Doppler ultrasound compared with electrocardiogram and pulse oximetry cardiac triggering: A pilot study
Corresponding Author
Fabian Kording
University Medical Centre Hamburg-Eppendorf, Centre for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, Germany
Correspondence to: Fabian Kording, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany. E-mail: [email protected]Search for more papers by this authorBjoern Schoennagel
University Medical Centre Hamburg-Eppendorf, Centre for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, Germany
Search for more papers by this authorGunnar Lund
University Medical Centre Hamburg-Eppendorf, Centre for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, Germany
Search for more papers by this authorFriedrich Ueberle
Hamburg University of Applied Sciences, Hamburg, Germany
Search for more papers by this authorCaroline Jung
University Medical Centre Hamburg-Eppendorf, Centre for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, Germany
Search for more papers by this authorGerhard Adam
University Medical Centre Hamburg-Eppendorf, Centre for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, Germany
Search for more papers by this authorJin Yamamura
University Medical Centre Hamburg-Eppendorf, Centre for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, Germany
Search for more papers by this authorCorresponding Author
Fabian Kording
University Medical Centre Hamburg-Eppendorf, Centre for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, Germany
Correspondence to: Fabian Kording, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany. E-mail: [email protected]Search for more papers by this authorBjoern Schoennagel
University Medical Centre Hamburg-Eppendorf, Centre for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, Germany
Search for more papers by this authorGunnar Lund
University Medical Centre Hamburg-Eppendorf, Centre for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, Germany
Search for more papers by this authorFriedrich Ueberle
Hamburg University of Applied Sciences, Hamburg, Germany
Search for more papers by this authorCaroline Jung
University Medical Centre Hamburg-Eppendorf, Centre for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, Germany
Search for more papers by this authorGerhard Adam
University Medical Centre Hamburg-Eppendorf, Centre for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, Germany
Search for more papers by this authorJin Yamamura
University Medical Centre Hamburg-Eppendorf, Centre for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, Germany
Search for more papers by this authorAbstract
Purpose
Accurate triggering of the cardiac cycle is mandatory for optimal image acquisition and thus diagnostic quality in cardiac magnetic resonance imaging. The purpose of this work was to evaluate Doppler ultrasound as an alternative trigger method in cardiac MRI.
Methods
Steady-state free precession (SSFP) 2D cine CMR was performed in 11 healthy subjects at 1.5T. Doppler ultrasound (DUS), electrocardiogram (ECG) and pulse oximetry (POX) were used for cardiac triggering. DUS peak detection was verified in comparison to ECG. Quantitative analysis of image quality of each gating method was determined by calculating endocardial border sharpness (EBS) and left ventricular (LV) function parameters and compared with ECG.
Results
Mean difference between DUS and ECG in detected RR intervals was 0.04 ± 63 ms (r = 0.96). Trigger jitter was not different between ECG and DUS (P = 0.15) but significant different between ECG and POX (P = 0.01). EBS was similar between each method (3.1 ± 0.2 / 2.6 ± 0.2 / 2.9 ± 0.2 pixel). Mean differences in stroke volume were not significantly different with −1 ± 7 mL (ECG/DUS, P = 0.9) and 2 ± 10 mL (ECG/POX, P = 0.8).
Conclusion
Cine cardiac MRI using DUS was successfully demonstrated. DUS triggering is an alternative method for cardiac MRI and may be applied in a clinical setting. Magn Reson Med 74:1257–1265, 2015. © 2014 Wiley Periodicals, Inc.
REFERENCES
- 1 Lanzer P, Barta C, Botvinick E, Wiesendanger H, Modin G, Higgins C. ECG-synchronized cardiac MR imaging: method and evaluation. Radiology 1985; 155: 681–686.
- 2 Keltner JR, Roos MS, Brakeman PR, Budinger TF. Magnetohydrodynamics of blood flow. Magn Reson Med 1990; 16: 139–149.
- 3
Fischer SE,
Wickline SA,
Lorenz CH. Novel real-time R-wave detection algorithm based on the vectorcardiogram for accurate gated magnetic resonance acquisitions. Magn Reson Med 1999; 42: 361–370.
10.1002/(SICI)1522-2594(199908)42:2<361::AID-MRM18>3.0.CO;2-9 CAS PubMed Web of Science® Google Scholar
- 4 Krug JW, Rose G, Clifford GD, Oster J. ECG-based gating in ultra high field cardiovascular magnetic resonance using an independent component analysis approach. J Cardiovasc Magn Reson 2013; 15: 104.
- 5
Martin V,
Drochon A,
Fokapu O,
Gerbeau J-F. Magnetohemodynamics effect on electrocardiograms. Functional imaging and modeling of the heart. New York: Springer; 2011. p 325–332.
10.1007/978-3-642-21028-0_42 Google Scholar
- 6 Kinouchi Y, Yamaguchi H, Tenforde T. Theoretical analysis of magnetic field interactions with aortic blood flow. Bioelectromagnetics 1996; 17: 21–32.
- 7 Brandts A, Westenberg JJ, Versluis MJ, Kroft LJ, Smith NB, Webb AG, de Roos A. Quantitative assessment of left ventricular function in humans at 7 T. Magn Reson Med 2010; 64: 1471–1477.
- 8 Chia JM, Fischer SE, Wickline SA, Lorenz CH. Performance of QRS detection for cardiac magnetic resonance imaging with a novel vectorcardiographic triggering method. J Magn Reson Imaging 2000; 12: 678–688.
- 9 Becker M, Frauenrath T, Hezel F, et al. Comparison of left ventricular function assessment using phonocardiogram-and electrocardiogram-triggered 2D SSFP CINE MR imaging at 1.5 T and 3.0 T. Eur Radiol 2010; 20: 1344–1355.
- 10 Kugel H, Bremer C, Püschel M, Fischbach R, Lenzen H, Tombach B, Van Aken H, Heindel W. Hazardous situation in the MR bore: induction in ECG leads causes fire. Eur Radiol 2003; 13: 690–694.
- 11 Shellock FG, Crues JV. MR procedures: biologic effects, safety, and patient care. Radiology 2004; 232: 635–652.
- 12 Hiba B, Richard N, Janier M, Croisille P. Cardiac and respiratory double self-gated cine MRI in the mouse at 7 T. Magn Reson Med 2006; 55: 506–513.
- 13 Frauenrath T, Hezel F, Renz W, de Geyer d'Orth T, Dieringer M, von Knobelsdorff-Brenkenhoff F, Prothmann M, Schulz-Menger J, Niendorf T. Acoustic cardiac triggering: a practical solution for synchronization and gating of cardiovascular magnetic resonance at 7 Tesla. J Cardiovasc Magn Reson 2010; 12: 67.
- 14 Feinberg DA, Giese D, Bongers DA, Ramanna S, Zaitsev M, Markl M, Günther M. Hybrid ultrasound MRI for improved cardiac imaging and real-time respiration control. Magn Reson Med 2010; 63: 290–296.
- 15 Günther M, Feinberg DA. Ultrasound-guided MRI: preliminary results using a motion phantom. Magn Reson Med 2004; 52: 27–32.
- 16 Petrusca L, Cattin P, De Luca V, et al. Hybrid ultrasound/magnetic resonance simultaneous acquisition and image fusion for motion monitoring in the upper abdomen. Invest Radiol 2013; 48: 333–340.
- 17 Feinberg D, Günther M. Simultaneous MR and ultrasound imaging: towards US-navigated MRI. In Proceedings of the 11th Annual Meeting of ISMRM, Toronto, Canada, 2003. Abstract 381.
- 18 Tang AM, Kacher DF, Lam EY, Wong KK, Jolesz FA, Yang ES. Simultaneous ultrasound and MRI system for breast biopsy: compatibility assessment and demonstration in a dual modality phantom. IEEE Trans Med Imaging 2008; 27: 247–254.
- 19 Rubin JM, Brian Fowlkes J, Prince MR, Rhee RT, Chenevert TL. Doppler US gating of cardiac MR imaging. Acad Radiol 2000; 7: 1116–1122.
- 20 Shakespeare SA, Moore RJ, Crowe JA, Gowland PA, Hayes-Gill BR. A method for foetal heart rate monitoring during magnetic resonance imaging using Doppler ultrasound. Physiol Meas 1999; 20: 363.
- 21
Ueberle F,
Dettmann E,
Eden C, et al. Cardiac MR: imaging of the foetal heart dynamics using doppler ultrasound triggering. Biomed Tech 2012; 57: 1.
10.1515/bmt-2012-4443 Google Scholar
- 22 Yamamura J, Kopp I, Frisch M, Fischer R, Valett K, Hecher K, Adam G, Wedegärtner U. Cardiac MRI of the fetal heart using a novel triggering method: initial results in an animal model. J Magn Reson Imaging 2012; 35: 1071–1076.
- 23 Schoennagel BP, Remus CC, Yamamura J, et al. Fetal blood flow velocimetry by phase-contrast MRI using a new triggering method and comparison with Doppler ultrasound in a sheep model: a pilot study. MAGMA 2014; 27: 237–244.
- 24 Jawad IA. A practical guide to echocardiography and cardiac doppler ultrasound. Philadelphia: Lippincott Williams & Wilkins; 1996.
- 25 Hirsch JA, Bishop B. Respiratory sinus arrhythmia in humans: how breathing pattern modulates heart rate. Am J Physiol Heart C 1981; 241: 620–629.
- 26 Alfakih K, Plein S, Thiele H, Jones T, Ridgway JP, Sivananthan MU. Normal human left and right ventricular dimensions for MRI as assessed by turbo gradient echo and steady-state free precession imaging sequences. J Magn Reson Imaging 2003; 17: 323–329.
- 27 Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307–310.
- 28
Felblinger J,
Slotboom J,
Kreis R,
Jung B,
Boesch C. Restoration of electrophysiological signals distorted by inductive effects of magnetic field gradients during MR sequences. Magn Reson Med 1999; 41: 715–721.
10.1002/(SICI)1522-2594(199904)41:4<715::AID-MRM9>3.0.CO;2-7 CAS PubMed Web of Science® Google Scholar
- 29 Jezewski J, Roj D, Wrobel J, Horoba K. A novel technique for fetal heart rate estimation from Doppler ultrasound signal. Biomed Eng Online 2011; 10: 1–17.
- 30 Peters C, ten Broeke E, Andriessen P, Vermeulen B, Berendsen R, Wijn P, Oei SG. Beat-to-beat detection of fetal heart rate: Doppler ultrasound cardiotocography compared to direct ECG cardiotocography in time and frequency domain. Physiol Meas 2004; 25: 585.
- 31 Wrobel J, Jezewski J, Roj D, Przybyla T, Czabanski R, Matonia A. The influence of Doppler ultrasound signal processing techniques on fetal heart rate variability measurements. Int J Biol Biomed Eng v4 i4 2010: 79–87.
- 32 Wiener N. Generalized harmonic analysis. Acta Math 1930; 55: 117–258.
- 33 Allen M, Kawamura DM, Craig M, Berman MC. Diagnostic medical sonography: echocardiography. Philadelphia: Lippincott Williams & Wilkins; 1998.
- 34 Hudsmith LE, Petersen SE, Francis JM, Robson MD, Neubauer S. Normal human left and right ventricular and left atrial dimensions using steady state free precession magnetic resonance imaging. J Cardiovasc Magn Reson 2005; 7: 775–782.
- 35 Maceira A, Prasad S, Khan M, Pennell D. Normalized left ventricular systolic and diastolic function by steady state free precession cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2006; 8: 417–426.
- 36 Liu G, Qi X-L, Robert N, Dick AJ, Wright GA. Ultrasound-guided identification of cardiac imaging windows. Med Phys 2012; 39: 3009–3018.
- 37 Tridandapani S, Fowlkes JB, Rubin JM. Echocardiography-based selection of quiescent heart phases implications for cardiac imaging. J Ultras Med 2005; 24: 1519–1526.
- 38 Wu V, Barbash IM, Ratnayaka K, Saikus CE, Sonmez M, Kocaturk O, Lederman RJ, Faranesh AZ. Adaptive noise cancellation to suppress electrocardiography artifacts during real-time interventional MRI. J Magn Reson Imaging 2011; 33: 1184–1193.
- 39 Gregory TS, Schmidt EJ, Zhang SH, Ho Tse ZT. 3DQRS: a method to obtain reliable QRS complex detection within high field MRI using 12-lead electrocardiogram traces. Magn Reson Med 2014; 71: 1374–1380.
- 40 Larson AC, White RD, Laub G, McVeigh ER, Li D, Simonetti OP. Self-gated cardiac cine MRI. Magn Reson Med 2004; 51: 93–102.
- 41 Frauenrath T, Niendorf T, Kob M. Acoustic method for synchronization of magnetic resonance imaging. Acta Acust United Ac 2008; 94: 148–155.
