Measurement of Myocardial Extracellular Volume Fraction by Using Equilibrium Contrast-enhanced CT: Validation against Histologic Findings
Measurement of Myocardial Extracellular Volume Fraction by Using Equilibrium Contrast-enhanced CT: Validation against Histologic Findings
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DOI：
10.1148/radiol.13130130
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发表时间：
2013-11-01
期刊：
影响因子：
19.7
通讯作者：
Moon, James C.
中科院分区：
文献类型：
--
作者：
Bandula, Steve;White, Steven K.;Moon, James C.
目的：开发和验证平衡对比材料增强计算机断层扫描（CT）通过使用组织学参考标准来测量心肌细胞外体积（ECV）分数，并将平衡CT与平衡对比增强磁共振（MR）成像进行比较。材料和方法：当地伦理委员会批准了该研究，所有受试者都给予了充分知情的书面同意。在严重主动脉瓣狭窄的患者中，采用碘碘浓度为每毫升300毫克（每公斤体重1毫克，以3ml /秒的速度给药，随后立即每小时输注1.88毫升/公斤，在注射造影剂前和注射后25分钟进行CT成像）和使用平衡CT和平衡MR成像测量心肌间隔内的ECV，制定了平衡CT方案。在瓣膜置换术中采集的心肌间隔活检样本用于细胞外纤维化的组织学定量，微天狼星红染色。利用Pearson相关性将平衡CT和平衡MR成像衍生的ECV测量值与组织学量化纤维化进行比较。平衡CT和平衡MR成像之间的一致性通过Bland-Altman比较进行评估。结果：共纳入23例患者，其中男性16例，女性7例，平均年龄70.8岁，标准差8.3。组织学纤维化的平均百分比为18%（受试者间范围为5%-40%）。平衡CT和平衡MR成像衍生的ECV与组织学纤维化百分比之间存在显著相关性（r = 0.71 [P < 0.001]和r = 0.84 [P < 0.001]）。平衡ct衍生的ECV与平衡MR成像衍生的ECV显著相关（r = 0.73）。结论：主动脉瓣狭窄患者使用平衡CT测量的ECV与心肌纤维化的组织学定量及平衡MR成像获得的ECV相关。(c) rsna, 2013
Purpose: To develop and validate equilibrium contrast material-enhanced computed tomography (CT) to measure myocardial extracellular volume (ECV) fraction by using a histologic reference standard and to compare equilibrium CT with equilibrium contrast-enhanced magnetic resonance (MR) imaging.Materials and Methods: A local ethics committee approved the study, and all subjects gave fully informed written consent. An equilibrium CT protocol was developed by using iohexol at 300 mg of iodine per milliliter (bolus of 1 mg per kilogram of body weight administered at a rate of 3 mL/sec, followed immediately by an infusion of 1.88 mL/kg per hour with CT imaging before and at 25 minutes after injection of bolus of contrast agent) and ECV within the myocardial septum measured using both equilibrium CT and equilibrium MR imaging in patients with severe aortic stenosis. Biopsy samples of the myocardial septum collected during valve replacement surgery were used for histologic quantification of extracellular fibrosis with picrosirius red staining. Equilibrium CT- and equilibrium MR imaging-derived ECV measurements were compared with histologically quantified fibrosis by using Pearson correlation. Agreement between equilibrium CT and equilibrium MR imaging was assessed by using Bland-Altman comparison.Results: Twenty-three patients (16 male, seven female; mean age, 70.8 years; standard deviation, 8.3) were recruited. The mean percentage of histologic fibrosis was 18% (inter-subject range, 5%-40%). There was a significant correlation between both equilibrium CT- and equilibrium MR imaging-derived ECV and percentage of histologic fibrosis (r = 0.71 [P < .001] and r = 0.84 [P < .0001], respectively). Equilibrium CT-derived ECV was significantly correlated to equilibrium MR imaging-derived ECV (r = 0.73).Conclusion: ECV measured by using equilibrium CT in patients with aortic stenosis correlates with histologic quantification of myocardial fibrosis and with ECV derived by using equilibrium MR imaging. (C) RSNA, 2013