Journal of Arrhythmia (Aug 2015)

Acquisition of the pulmonary venous and left atrial anatomy with non-contrast-enhanced MRI for catheter ablation of atrial fibrillation: Usefulness of two-dimensional balanced steady-state free precession

  • Yutaka Shigenaga, RT,
  • Kunihiko Kiuchi, MD,
  • Katsunori Okajima, MD,
  • Kazushi Ikeuchi, RT,
  • Takayuki Ikeda, RT,
  • Akira Shimane, MD,
  • Kiminobu Yokoi, MD,
  • Jin Teranishi, MD,
  • Kousuke Aoki, MD,
  • Misato Chimura, MD,
  • Hideyuki Masai, RT,
  • Shinichiro Yamada, MD,
  • Yasuyo Taniguchi, MD,
  • Yoshinori Yasaka, MD,
  • Hiroya Kawai, MD

DOI
https://doi.org/10.1016/j.joa.2014.11.006
Journal volume & issue
Vol. 31, no. 4
pp. 189 – 195

Abstract

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Background: Usually, the pulmonary venous and left atrial (PV–LA) anatomy is assessed with contrast-enhanced computed tomographic imaging for catheter ablation of atrial fibrillation (AF). A non-contrast-enhanced magnetic resonance (MR) imaging method has not been established. Three-dimensional balanced steady-state free precession (3D b-SSFP) sequences cannot visualize the PV–LA anatomy simultaneously because of the signal intensity defect of pulmonary veins. We compared two-dimensional (2D) b-SSFP sequences with 3D b-SSFP sequences in depicting the PV–LA anatomy with non-contrast-enhanced MR imaging for AF ablation. Methods: Eleven healthy volunteers underwent non-contrast-enhanced MR imaging with 3D b-SSFP and 2D b-SSFP sequences. The MR images were reconstructed on the 3D PV–LA surface image. Two experienced radiological technicians independently scored the multiplanar reformatted (MPR) images on a scale of 1–4 (from 1, not visualized, to 4, excellent definition). The overall score was a sum of 5 segments (LA and 4 PVs). Results: In the 2D b-SSFP method, MR imaging was successfully performed, and the 3D PV–LA surface image was precisely reconstructed in all healthy volunteers. The image score was significantly higher in the 2D b-SSFP method compared to the 3D b-SSFP method (19 [19; 20] vs. 12 [11; 15], p=0.004, for both observers). No PV signal intensity defects occurred in the 2D b-SSFP method. Conclusions: The 2D b-SSFP sequence was more useful than the 3D b-SSFP sequence in adequately depicting the PV–LA anatomy.

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