Improved border sharpness of post-infarct scar by a novel self-navigated free-breathing high-resolution 3D whole-heart inversion recovery magnetic resonance approach
Improved border sharpness of post-infarct scar by a novel self-navigated free-breathing high-resolution 3D whole-heart inversion recovery magnetic resonance approach
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DOI：
10.1007/s10554-016-0963-4
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发表时间：
2016-12-01
影响因子：
2.1
通讯作者：
Schwitter, Juerg
中科院分区：
文献类型：
--
作者：
Rutz, Tobias;Piccini, Davide;Schwitter, Juerg
通过晚期钆增强 (LGE) 识别的梗死后心肌疤痕的边界区域已被确定为心律失常的基础，因此，高分辨率 3D 疤痕信息对于规划电生理干预措施可能有用。本研究评估了新型高分辨率 3D 自导航自由呼吸反转恢复磁共振脉冲序列 (3D-SN-LGE) 与传统 2D 屏气 LGE (2D-LGE) 在梗死后疤痕边界锐度 (S-Border) 方面的性能。梗塞后疤痕患者接受了两次 1.5T 磁共振检查，以获取常规 2D-LGE 和高分辨率 3D-SN-LGE 采集（均在 0.2 mmol/kg Gadobutrol IV 后 15 分钟）。在原型 3D-SN-LGE 序列中，每个 ECG 触发的径向稳态无进动读出段之前都有一个非切片选择性反转脉冲。在 2D-LGE 和匹配重建的高分辨率 3D-SN-LGE 短轴切片上评估疤痕体积和 SBorder。在 16 名患者（四名女性，58 +/- 10 岁）中，2D-LGE 可视化的所有疤痕均可在 3D-SN-LGE 上识别（2D-LGE 和 3D-SN-LGE 之间的时间为 48 +/- 53 天）。 3D-SN-LGE 与 2D-LGE 的疤痕体积具有良好的一致性（Bland-Altman：-3.7 +/- 3.4 ml，相关性：r = 0.987，p < 0.001），疤痕体积差异较小（分别为 20.5 (15.8, 35.2) ml 与 24.5 (20.0, 41.9)) ml，p = 0.002]和良好的观察者内和观察者间变异性（分别为1.1 +/- 4.1和-1.1 +/- 11.9 ml）。边界“疤痕到非梗塞心肌”的 SBorder 在 3D-SN-LGE 上优于 2D-LGE：0.180 +/- 0.044 与 0.083 +/- 0.038，p < 0.001。与 2D-LGE 相比，3D-SN-LGE 对心肌疤痕的检测和量化是可行且准确的。 3D 序列的高空间分辨率改善了疤痕边界的描绘。
The border zone of post-infarction myocardial scar as identified by late gadolinium enhancement (LGE) has been identified as a substrate for arrhythmias and consequently, high-resolution 3D scar information is potentially useful for planning of electrophysiological interventions. This study evaluates the performance of a novel high-resolution 3D self-navigated free-breathing inversion recovery magnetic resonance pulse sequence (3D-SN-LGE) vs. conventional 2D breath-hold LGE (2D-LGE) with regard to sharpness of borders (S-Border) of post-infarction scar. Patients with post-infarction scar underwent two magnetic resonance examinations for conventional 2D-LGE and high-resolution 3D-SN-LGE acquisitions (both 15 min after 0.2 mmol/kg Gadobutrol IV) at 1.5T. In the prototype 3D-SN-LGE sequence, each ECG-triggered radial steady-state-free-precession read-out segment is preceded by a non-slice-selective inversion pulse. Scar volume and SBorder were assessed on 2D-LGE and matching reconstructed high-resolution 3D-SN-LGE short-axis slices. In 16 patients (four females, 58 +/- 10y) all scars visualized by 2D-LGE could be identified on 3D-SN-LGE (time between 2D-LGE and 3D-SN-LGE 48 +/- 53 days). A good agreement of scar volume by 3D-SN-LGE vs. 2D-LGE was found (Bland-Altman: -3.7 +/- 3.4 ml, correlation: r = 0.987, p < 0.001) with a small difference in scar volume (20.5 (15.8, 35.2) ml vs. 24.5 (20.0, 41.9)) ml, respectively, p = 0.002] and a good intra- and interobserver variability (1.1 +/- 4.1 and -1.1 +/- 11.9 ml, respectively). SBorder of border "scar to non-infarcted myocardium" was superior on 3D-SN-LGE vs. 2D-LGE: 0.180 +/- 0.044 vs. 0.083 +/- 0.038, p < 0.001. Detection and quantification of myocardial scar by 3D-SN-LGE is feasible and accurate in comparison to 2D-LGE. The high spatial resolution of the 3D sequence improves delineation of scar borders.