Usefulness of segmented TrueFISP cardiac pulse sequence in evaluation of congenital and acquired adult cardiac abnormalities

OBJECTIVE. The purpose of this study is to compare ultrashort TR, segmented trueFISP (fast imaging with steady-state precession) cine MR imaging with segmented FLASH (fast low-angle shot) cine NM imaging for the detection and characterization of congenital and acquired adult cardiac abnormalities. SUBJECTS AND METHODS. Twenty-five patients with known or clinically suspect ed cardiac abnormalities were imaged on a 1.5-T scanner. Valve plane movies were obtained in patients with suspected valve morphology or function abno rmalities or whose horizontal long-axis images showed jets, For each patien t, three radiologists independently compared corresponding matched cine FLA SH and trueFISP movies for image quality in evaluating anatomy and function of the great vessels and heart. Image quality was rated on a five-point sc ale, and data were analyzed using both a Wilcoxon's signed rank test and a repeated-measures analysis of variance. RESULTS. Image quality ratings of trueFISP and FLASH showed a statistically significant difference (F = 58.67 df = 1, 72; p < 0.0001), with the averag e rating for the trueFISP images being significantly higher (mean rating, 4 .1 +/- 0.92) than that for the FLASH images (mean, 3.0 +/- 1.0). However, v alve architecture in the aortic valves appeared to be better visualized and was more easily measured in valve plane images with FLASH. No statisticall y significant differences among the ratings of the interpreters (F = 0.018; df = 2, 72; p = 0.9821) were evident, and, therefore, no suggestion of bia s was indicated (F = 0.775; df = 1, 2; p = 0.4645). TrueFISP yielded the co rrect diagnosis prospectively in 13 (100%) of 13 patients, whereas FLASH yi elded the correct diagnosis in 12 (92%) of 13 patients. CONCLUSION. TrueFISP images depict morphologic and functional abnormalities with greater clarity and provide greater diagnostic confidence than FLASH images-and in a fraction of the time. A specific exception is in the assess ment of valve leaflet architecture and cross-sectional area calculation (i. e., bicuspid aortic valves); in these evaluations, FLASH maintains a comple mentary diagnostic imaging role.