Delayed-enhanced MR scar imaging and intraprocedural registration into an electroanatomical mapping system in post-infarction patients.
Delayed-enhanced MR scar imaging and intraprocedural registration into an electroanatomical mapping system in post-infarction patients.
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DOI：
10.1016/j.jcmg.2011.08.021
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发表时间：
2012-02
影响因子：
14
通讯作者：
Bogun, Frank
中科院分区：
文献类型：
--
作者：
Gupta, Sanjaya;Desjardins, Benoit;Baman, Timir;Ilg, Karl;Good, Eric;Crawford, Thomas;Oral, Hakan;Pelosi, Frank;Chugh, Aman;Morady, Fred;Bogun, Frank
梗死后心律失常通常局限于瘢痕组织。疤痕可以通过延迟增强磁共振成像（DE-MRI）检测到。本研究的目的是评估23例既往梗死和室性心律失常（VA）患者手术前疤痕识别和术中实时图像配准的可行性。评估了登记准确性和MRI/EAM相关性，VA的关键区域与疤痕的存在相关。EAM的位置配准误差为3.8±0.8 mm， 86%的低压点投射到所配准的疤痕上。DE-MRI定义的瘢痕与低电压面积相关（R=0.82, p<0.001）。所有重要的部位都投射在疤痕上。选择性地识别和提取DE-MRI定义的疤痕，并将其注册到实时制图系统中是可行的，有助于识别和显示梗死后VAs患者的致心律失常底物。
Post-infarction arrhythmias are most often confined to scar tissue. Scar can be detected by delayed enhanced magnetic resonance imaging (DE-MRI). The purpose of this study was to assess the feasibility of pre-procedural scar identification, and intra-procedural real-time image registration with an electroanatomical map (EAM) in 23 patients with prior infarction and ventricular arrhythmias (VA). Registration accuracy and MRI/EAM correlations were assessed and critical areas for VA were correlated with the presence of scar. With a positional registration error of 3.8±0.8 mm, 86% of low voltage points of the EAM projected onto the registered scar. The DE-MRI defined scar correlated with the area of low voltage (R=0.82, p<0.001). All sites critical to VAs projected on the registered scar. Selective identification and extraction of DE-MRI defined scar followed by registration into a real-time mapping system is feasible and helps to identify and display the arrhythmogenic substrate in post-infarction patients with VAs.
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