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Low b-values Diffusion Weighted Imaging of the in vivo human heart

Abstract : Diffusion weighted magnetic resonance imaging (DW-MRI, or DWI) enables the access to the structural information of body tissues through the reading of water molecules Brownian motion. Its applications are many in brain imaging, from clinical practice to research. However physiological motion induces an additional signal-loss when diffusion encoding is applied. This motion-induced signal-loss limits greatly its applications in cardiac imaging. Using low diffusion-weighting values (b) DWI reduces this sensitivity but permits only the imaging of intravoxel incoherent motion (IVIM), which combines both water diffusion and perfusion. IVIM imaging has many applications in body MRI, from tissue characterization to perfusion quantification but remains unexplored for the imaging of the heart. The purpose of this work was to evaluate the context of low b-values DWI imaging of the heart, propose methodological contributions and then apply the developed techniques experimentally. We identified cardiac motion as one of the major sources of motion-induced signal loss. Although bulk motion can be corrected with a non-rigid registration algorithm, additional signal-loss remains uncorrected for and prevents accurate DWI of the myocardium. The study of diffusion-weighted signal-loss induced by cardiac motion in a volunteer provided a time-window when motion is at minimum in diastole. Within this optimal time-window, fluctuation of intensity attests of variable remaining physiological motion. A solution to repeat acquisition with shifted trigger-times ease the capture of motion amplitude minima, i.e. DWI-intensity maxima. Temporal maximum intensity projection (TMIP) finally retrieves diffusion weighted images of minimal motion-induced signal-loss. We evaluated various attempts of sequence development with TMIP: usual spin-echo echo-planar imaging (se-EPI) sequence can be improved but suffers aliasing issues; a balanced steady-state free-precession (b-SSFP) combined with a diffusion preparation is more robust to spatial distortions but typical banding artifacts prevent its applicability; finally a state-of-the-art double-spin-echo EPI sequence produces less artifacted DWI results. With this sequence, TMIP-DWI proves to significantly reduce motion-induced signal-loss in the imaging of the myocardium. The drawback with TMIP comes from noise spikes that can easily be highlighted. To compensate for TMIP noise sensitivity, we separated noise spikes from smooth fluctuation of intensity using a novel approach based on localized principal component analysis (PCA). The decomposition was made so as to preserve anatomical features while increasing signal and contrast to 9 noise ratios (SNR, CNR). With PCATMIP- DWI, both signal-intensity and SNR are increased theoretically and experimentally. Benefits were quantified in a simulation before being validated in volunteers. Additionally the technique showed reproducible results in a sample of acute myocardial infarction (AMI) patients, with a contrast matching the extent and location of the injured area. Contrarily to brain imaging, in vivo low b-values DWI should be differentiated from ex vivo DWI pure diffusion measurements. Thus PCATMIP-DWI might provide an injection-free technique for exploring cardiac IVIM imaging. Early results encourage the exploration of PCATMIP-DWI in an experimental model of cardiac diseases. Moreover the access to higherb values would permit the study of the full IVIM model for the human heart that retrieves and separates both perfusion and diffusion information.
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https://hal-amu.archives-ouvertes.fr/tel-02117865
Contributor : Stanislas Rapacchi <>
Submitted on : Tuesday, May 7, 2019 - 4:29:01 PM
Last modification on : Wednesday, August 19, 2020 - 12:08:22 PM
Long-term archiving on: : Monday, September 30, 2019 - 9:32:40 PM

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Stanislas Rapacchi. Low b-values Diffusion Weighted Imaging of the in vivo human heart. Imaging. Université de Lyon - Université Claude Bernard Lyon1, 2011. English. ⟨tel-02117865⟩

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