Clinical Validation of a 3-Dimensional Ultrafast Cardiac Magnetic Resonance Protocol Including Single Breath-Hold 3-Dimensional Sequences Articles uri icon


  • Gomez Talavera, Sandra
  • Fernandez Jimenez, Rodrigo
  • Fuster, Valentin
  • Nothnagel, Nils D.
  • Kouwenhoven, Marc
  • Clemence, Matthew
  • Garcia Lunar, Ines
  • Gomez Rubin, Maria C.
  • Navarro, Felipe
  • Perez Asenjo, Braulio
  • Fernandez Friera, Leticia
  • Calero, Maria J.
  • Orejas, Miguel
  • Cabrera, Jose A.
  • Pizarro, Gonzalo
  • Ibanez, Borja
  • Sanchez-Gonzalez, Javier

publication date

  • September 2021

start page

  • 1742

end page

  • 1754


  • 9


  • 14

International Standard Serial Number (ISSN)

  • 1936-878X


  • Objectives: This study sought to clinically validate a novel 3-dimensional (3D) ultrafast cardiac magnetic resonance (CMR) protocol including cine (anatomy and function) and late gadolinium enhancement (LGE), each in a single breath-hold.

    Background: CMR is the reference tool for cardiac imaging but is time-consuming.

    Methods: A protocol comprising isotropic 3D cine (Enhanced sensitivity encoding [SENSE] by Static Outer volume Subtraction [ESSOS]) and isotropic 3D LGE sequences was compared with a standard cine+LGE protocol in a prospective study of 107 patients (age 58 ± 11 years; 24% female). Left ventricular (LV) mass, volumes, and LV and right ventricular (RV) ejection fraction (LVEF, RVEF) were assessed by 3D ESSOS and 2D cine CMR. LGE (% LV) was assessed using 3D and 2D sequences.

    Results: Three-dimensional and LGE acquisitions lasted 24 and 22 s, respectively. Three-dimensional and LGE images were of good quality and allowed quantification in all cases. Mean LVEF by 3D and 2D CMR were 51 ± 12% and 52 ± 12%, respectively, with excellent intermethod agreement (intraclass correlation coefficient [ICC]: 0.96; 95% confidence interval [CI]: 0.94 to 0.97) and insignificant bias. Mean RVEF 3D and 2D CMR were 60.4 ± 5.4% and 59.7 ± 5.2%, respectively, with acceptable intermethod agreement (ICC: 0.73; 95% CI: 0.63 to 0.81) and insignificant bias. Both 2D and 3D LGE showed excellent agreement, and intraobserver and interobserver agreement were excellent for 3D LGE.

    Conclusions: ESSOS single breath-hold 3D CMR allows accurate assessment of heart anatomy and function. Combining ESSOS with 3D LGE allows complete cardiac examination in less than 1 min of acquisition time. This protocol expands the indication for CMR, reduces costs, and increases patient comfort. (J Am Coll Cardiol Img 2021;14:1742–1754)


  • Biology and Biomedicine


  • accelerated protocol; contrast media; gadolinium; heart; magnetic resonance; myocardium