Accelerated whole-heart 3D CSPAMM for myocardial motion quantification

Myocardial tissue tagging using complementary spatial modulation of magnetization (CSPAMM) allows detailed assessment of myocardial motion. To capture the complex 3D cardiac motion pattern, multiple 2D tagged slices are usually acquired in different orientations. These approaches are prone to slice misregistration and associated with long acquisition times. In this work, a fast method for acquiring 3D CSPAMM data is proposed that allows measuring deformation of the whole heart in three breath-holds of 18 heartbeats duration each. Three acquisitions are sequentially performed with line tag preparation in each orthogonal direction. Measurement acceleration is achieved by applying localized tagging preparation and a hybrid multishot, segmented echo-planar imaging sequence. Five healthy volunteers and five patients with myocardial infarction were measured. Midwall contours were tracked throughout the cardiac cycle with an enhanced variant of the harmonic phase (HARP) technique. Circumferential shortening at end-systole ranged from 14.1% (base) to 20.1% (apex) in healthy subjects. Hypokinetic regions in patients corresponded well with regions exhibiting hyperenhancement after contrast injection. Time to maximum circumferential shortening varied more significantly over the left ventricle in patients than in volunteers (P < 0.01). The proposed measurement scheme was well tolerated by patients and holds considerable potential to investigate cardiac mechanics in various diseases.