Fig. 4

Representative balanced steady-state free precession short-axis images of 5 patients (columns) with combined clinical scores: breath-hold (BH) with SENSE factor of 2 (top row), breath-hold with C-SENSE factor of 3 (middle row), and free-breathing (FB) with C-SENSE factor of 3(bottom row). The combined image quality score is the equal-weight average of score in three criteria: blood-to-myocardial contrast (BMC), endocardial edge definition (EED), and presence of artifacts throughout the cardiac cycle. Each criterion was graded on a scale of 1 to 5, where 1 is nondiagnostic, 2 is suboptimal but still diagnostic for volumetric analysis, 3 is adequate, 4 is good, and 5 is excellent. Patient in (1) had dark papillary muscles and endocardial trabeculae clearly visible with crisp edge definition on bright backdrop of the blood pool throughout the cardiac cycle in all slices in all the three sequences. Patient in (2) had mild degradation of edge definition in all three sequences. For the patient in (3), there was mild degradation of edge definition only in FB C-SENSE sequence in couple of slices. Patient in (4) had mild degradation of edge definition for all three sequences, additionally both BH C-SENSE and FB C-SENSE sequences had slightly less BMC. For patient in (5), there were mild parallel imaging and motion artifacts for BH SENSE sequence, while BH C-SENSE sequence had only mild degradation of the edge definition, and FB C-SENSE sequences had substantial motion artifacts. BH = breath-hold, FB = free-breathing cardiorespiratory synchronized retrospectively cardiac gated balanced steady-state free precession cine CMR sequence