Assessment of Myocardial Viability with Magnetic Resonance Imaging

Accurate assessment of myocardial viability is a central goal in clinical diagnosis of ischemic heart disease, as well as in basic research into the underlying mechanisms of cardiac pathology. Clinical assessment of myocardial viability would have a significant impact on the management of patients with ischemic heart disease, by avoiding unnecessary revascularization procedures, as well as assessing the outcome of such interventions. In this work, two different approaches towards the assessment of myocardial viability using magnetic resonance imaging (MRI), will be investigated: 1. Development of near real time MR cardiac stress testing in humans. 2. Development of new methodologies towards estimates of tissue metabolic viability by determination of regional oxygen consumption. Towards the development of an MR cardiac stress test, an ultra-fast spoiled gradient echo (SPGR) imaging sequence was written for the new 5.6 GE scanner. Through the use of improved gradient hardware and the hardware optimized trapezoid (HOT) algorithm, this sequence reduced imaging times by half, from previous fast SPGR sequences. A detailed SNR analysis of SPGR imaging, was conducted and it was shown that SNR depends on relatively few parameters, most notably sequence efficiency. Most notably it was shown that image SNR is independent of TR when scan time is held constant. Designed for stress-testing with parallel tagging capabilities, the readout acquisition of this sequence sequence was modified to form a multi-echo hybrid sequence. Significant reductions in total scan time are possible with this sequence which is approximately 30-40% faster than single echo sequences. A