Intravoxel incoherent motion imaging with phase-cycled stimulated-echoes for simultaneous cardiac diffusion tensor and perfusion imaging

Motivation: Intravoxel incoherent motion (IVIM) imaging can provide information about cardiac microstructure and microvascular perfusion from a single examination. Current spin-echo based approaches for cardiac IVIM suffer from low perfusion sensitivity. Goal(s): We implemented a stimulated-echo (STEAM)-based method for cardiac IVIM and diffusion tensor imaging to enable accurate cardiac diffusion and perfusion imaging in vivo in the human heart. Approach: We introduced a novel IVIM-STEAM sequence incorporating phase cycling to obtain true b=0 s/mm2 images. Results: We tested the feasibility of our approach in 9 healthy subjects and obtained homogeneous perfusion and diffusion tensor maps, with values in the range described in the literature. Impact: Phase-cycled IVIM-STEAM provides good quality images that enable reliable fitting of cardiac diffusion tensor and perfusion parameters in healthy subjects. This approach may identify areas of microstructural aberration and perfusion abnormalities in patients with cardiovascular disease without exogenous contrast agents.