Myocardial Viability Mapping by Magnetic Resonance-Based Multiparametric Systolic Strain Analysis
Myocardial Viability Mapping by Magnetic Resonance-Based Multiparametric Systolic Strain Analysis
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DOI：
10.1016/j.athoracsur.2008.06.072
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发表时间：
2008-11-01
影响因子：
4.6
通讯作者：
Pasque, Michael K.
中科院分区：
文献类型：
--
作者：
Cupps, Brian P.;Bree, Douglas R.;Pasque, Michael K.
背景。区域心肌收缩力可以通过射频组织标记网格点位移的连续磁共振成像生成的三维左心室（LV）多参数应变图来表征。方法。通过应用基于磁共振的三维应变分析，从正常志愿者人体应变数据库 (n = 50) 确定 15,300 个 LV 点处三个应变指数中每一个的正常平均值和标准偏差值。然后将每位缺血性心肌病患者 (n = 20) 的患者特异性多参数应变数据提交给正常应变数据库进行逐点比较（n = 15,300 LV 点）。由此产生的 15,300 个复合多参数 Z 评分值（正常平均值的标准差）被绘制在患者特定的三维 LV 几何结构上的颜色轮廓，以检测与心肌梗塞和非存活心肌相关的异常收缩模式。结果。将每个 LV 区域 (n = 120) 的平均多参数应变复合 Z 评分与相应的临床标准活力测试结果进行比较，并用于构建接收者-操作者特征曲线。曲线下面积为 0.941（p < 0.001；95% 置信区间：0.897 至 0.985）。区域平均 Z 分数阈值为 1.525（> 1.525 为无活力）导致敏感性为 90%，特异性为 90%。相应的阳性和阴性预测值分别为 84% 和 95%。结论。基于磁共振的多参数应变分析的临床应用可以实现左心室心肌活力的准确区域表征和可视化。
Background. Regional myocardial contractility can be characterized by three-dimensional left ventricular (LV) multiparametric strain maps generated from sequential magnetic resonance imaging of radiofrequency tissue-tagging grid point displacements.Methods. Normal average and standard deviation values for each of three strain indices at 15,300 LV points were determined from a normal volunteer human strain database ( n = 50) by application of magnetic resonance-based three-dimensional strain analysis. Patient-specific multiparametric strain data from each ischemic cardiomyopathy patient ( n = 20) were then submitted to a point-by-point comparison ( n = 15,300 LV points) to the normal strain database. The resulting 15,300 composite multiparametric Z-score values ( standard deviation from normal average) were color-contour mapped over patient-specific three-dimensional LV geometry to detect the abnormal contractile patterns associated with myocardial infarction and nonviable myocardium.Results. The average multiparametric strain composite Z-score from each LV region ( n = 120) was compared with the respective clinical standard viability testing result and used to construct a receiver-operator characteristic curve. The area under the curve was 0.941 ( p < 0.001; 95% confidence interval: 0.897 to 0.985). A regional average Z-score threshold of 1.525 (> 1.525 being nonviable) resulted in a sensitivity of 90% and a specificity of 90%. Corresponding positive and negative predictive values were 84% and 95%, respectively.Conclusions. The clinical application of magnetic resonance-based multiparametric strain analysis allowed accurate regional characterization and visualization of LV myocardial viability.