Real-time radial tagging for quantification of left ventricular torsion

PURPOSE: To develop a real-time radial tagging MRI for accurate measurement of rotational motion and twist of the left ventricle (LV).

METHODS: A FLASH-based radial tagging sequence with an undersampled radial reading scheme was developed for both single and double-slice imaging in real-time. The Polar Fourier Transform was used for reconstruction to push the undersampling artifacts out of a reduced FOV. The developed technique was used to image five normal subjects during rest, plus one during both exercise and rest conditions. LV rotational motions were estimated for five consecutive cardiac cycles in all cases. The process was validated using a numerical phantom. The real-time measurement of global rotational motion was compared with those measured from a non-real-time exam using linear regression analysis and the Bland-Altman plot.

RESULTS: The real-time acquisition was performed successfully with a temporal resolution of 46.2 ms. Image quality was sufficient for the reproducible calculation of rotation at rest and exercise. The feasibility of double-slice acquisition on human was further studied and a real-time twist of the left ventricle was demonstrated. The difference between LV global rotations from real-time and non-real-time approaches was 0.27 degrees. A significant reverse recoiling, induced by exercise, was reproducibly measured by the technique.

CONCLUSION: A real-time radial tagging MRI technique was developed based on the undersampled radial acquisition and Polar Fourier Transform reconstruction, for accurate measuring of the heart rotational motion and twist. The technique was able to extract a meaningful change of diastolic recoiling under stress test conditions during physical activities (cycling).