Qualitative and quantitative analysis of regional left ventricular wall dynamics using real-time magnetic resonance imaging: comparison with conventional breath-hold gradient echo acquisition in volunteers and patients.

A real-time magnetic resonance imaging (MRI) acquisition sequence was evaluated for the assessment of left ventricular wall motion (WM) and wall thickening (WT). Ten normal volunteers and 21 patients were studied. Short-axis cine images of the left ventricle (LV) were acquired with a fast gradient echo and an ultrafast segmented echo-planar imaging (EPI) sequence. Qualitative and quantitative analysis of WM and WT was performed on a segmental basis. Qualitative scores agreed between the two methods in 691 of 724 segments (95.4%) with good reproducibility. Quantitative measurements of WM and WT were significantly lower (P < 0.001) with the real-time method (WM: mean bias, 0.49 mm; WT: mean bias, 0.61 mm). The largest differences were observed in the anterior and lateral segments and in patients with dilated ventricles. The lower resolution of the real-time sequence and artifacts was probably responsible for these differences. In conclusion, real-time cardiac MRI can be used for qualitative assessment of wall dynamics but is presently insufficient for quantitative analysis.