Comprehensive Validation of Cardiovascular Magnetic Resonance Techniques for the Assessment of Myocardial Extracellular Volume
Comprehensive Validation of Cardiovascular Magnetic Resonance Techniques for the Assessment of Myocardial Extracellular Volume
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DOI：
10.1161/circimaging.112.000192
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发表时间：
2013-05-01
影响因子：
7.5
通讯作者：
Schmitt, Matthias
中科院分区：
文献类型：
--
作者：
Miller, Christopher A.;Naish, Josephine H.;Schmitt, Matthias
背景-细胞外基质扩张是心室重塑的关键因素，也是潜在的治疗靶点。心血管磁共振(CMR)T-1标测技术越来越多地被用于评估心肌细胞外体积(ECV)；然而，最广泛应用的方法没有组织学验证。我们的目的是对(1)动态平衡CMR(dyneq-CMR)进行全面的验证，其中ECV是用血细胞比容调整的心肌和血液T-1值在Gd团注前后测量的；(2)单独测量心肌T-1，作为ECV的替代物。方法和结果-采用96个组织样本进行全心组织学验证，分析从心脏移植前预期接受CMR(CMR和移植之间的中位间隔，29天)的16个心脏节段的每个心脏节段的印微天狼星红胶原体积分数。用改良的Look-Locker反转恢复序列在造影剂前、造影剂后10分钟和15分钟进行T-1测量，计算动态Eq-CMR获得的ECV。另外，对30名健康志愿者在造影剂后2~20分钟测量ECV。动态Eq-CMR来源的ECV与组织学胶原体积分数呈显著的线性关系(P
Background-Extracellular matrix expansion is a key element of ventricular remodeling and a potential therapeutic target. Cardiovascular magnetic resonance (CMR) T-1-mapping techniques are increasingly used to evaluate myocardial extracellular volume (ECV); however, the most widely applied methods are without histological validation. Our aim was to perform comprehensive validation of (1) dynamic-equilibrium CMR (DynEq-CMR), where ECV is quantified using hematocrit-adjusted myocardial and blood T-1 values measured before and after gadolinium bolus; and (2) isolated measurement of myocardial T-1, used as an ECV surrogate.Methods and Results-Whole-heart histological validation was performed using 96 tissue samples, analyzed for picrosirius red collagen volume fraction, obtained from each of 16 segments of the explanted hearts of 6 patients undergoing heart transplantation who had prospectively undergone CMR before transplantation (median interval between CMR and transplantation, 29 days). DynEq-CMR-derived ECV was calculated from T-1 measurements made using a modified Look-Locker inversion recovery sequence before and 10 and 15 minutes post contrast. In addition, ECV was measured 2 to 20 minutes post contrast in 30 healthy volunteers. There was a strong linear relationship between DynEq-CMR-derived ECV and histological collagen volume fraction (P