Left ventricular function assessment using a fast 3D gradient echo pulse sequence: Comparison to standard multi-breath hold 2D steady state free precession imaging and accounting for papillary muscles and trabeculations

Objective Papillary muscles and trabeculae for ventricular function analysis are known to significantly contribute to accurate volume and mass measurements. Fast imaging techniques such as three-dimensional steady-state free precession (3D SSFP) are increasingly being used to speed up imaging time, but sacrifice spatial resolution. It is unknown whether 3D SSFP, despite its reduced spatial resolution, allows for exact delineation of papillary muscles and trabeculations. We therefore compared 3D SSFP ventricular function measurements to those measured from standard multi-breath hold two-dimensional steady-state free precession cine images (standard 2D SSFP). Methods and results 14 healthy subjects and 14 patients with impaired left ventricular function underwent 1.5 Tesla cine imaging. A stack of short axis images covering the left ventricle was acquired with 2D SSFP and 3D SSFP. Left ventricular volumes, ejection fraction, and mass were deter- mined. Analysis was performed by substracting papillary muscles and trabeculae from left ventricular volumes. In addition, reproducibility was assessed. EDV, ESV, EF, and mass were not significantly different between 2D SSFP and 3D SSFP (mean difference healthy subjects: -0.06 ± 3.2 ml, 0.54 ± 2.2 ml, -0.45 ± 1.8%, and 1.13 ± 0.8 g, respectively; patients: 1.36 ± 2.8 ml, -0.15 ± 3.5 ml, 0.86 ± 2.5%, and 0.91 ± 0.9 g, respectively; P ≥ 0.095). Intra- and interob- server variability was not different for 2D SSFP (P ≥ 0.64 and P ≥ 0.397) and 3D SSFP (P ≥ 0.53 and P ≥ 0.47). Conclusions Differences in volumes, EF, and mass measurements between 3D SSFP and standard 2D SSFP are very small, and not statistically significant. 3D SSFP may be used for accurate ventricular function assessment when papillary muscles and trabeculations are to be taken into account.