Effects of time, dose, and inversion time for acute myocardial infarct size measurements based on magnetic resonance imaging-delayed contrast enhancement
Effects of time, dose, and inversion time for acute myocardial infarct size measurements based on magnetic resonance imaging-delayed contrast enhancement
复制标题
DOI：
10.1016/j.jacc.2006.01.059
复制
发表时间：
2006-05-16
影响因子：
24
通讯作者：
Judd, Robert M.
中科院分区：
文献类型：
--
作者：
Wagner, Anja;Mahrholdt, Heiko;Judd, Robert M.
目的 本研究旨在调查时间、剂量和反转时间 (TI) 的影响及其对心肌梗塞面积测量的相互作用，为多中心试验的标准化方案奠定基础。 背景 人们越来越关注使用磁共振成像 (MRI) 梗塞面积测量作为临床试验的终点。然而，不存在标准化方案，并且关于时间、造影剂剂量和 TI 影响的数据有限。方法首先，我们确定了对比后成像时间（5 至 40 分钟）、造影剂剂量（0.1 与 0.2 mmol/kg）、TI 的影响以及它们在动物模型（n = 14）中的相互作用。其次，我们测试了动物研究的结果是否适用于患者并且具有普遍性。因此，我们在多中心研究中重新测试了诊断窗口。使用调整后的 TI 注射 0.15 mmol/kg 二亚乙基三胺五乙酸钆后，对来自三个中心的总共 48 名首次急性心肌梗死 (AMI) 患者进行了两次成像（5 分钟和 30 分钟）。 结果动物研究表明，使用调整后的 TI，梗死面积与时间和剂量无关（分别为 p = 0.9 和 p = 0.16）。然而，使用固定 TI，梗死面积是时间和剂量的函数（分别为 p = 0.0001 和 p = 0.01）。多中心研究表明，MRI 1（左心室的 16.9 +/- 12%）与 MRI 2（左心室的 16.4 +/- 12%，p = NS）没有统计学差异，部位之间没有差异（p = NS）。 结论 可以使用 MRI 测量 AMI 大小，使用 0.1 至 0.2 mmol/kg 之间的造影剂剂量，造影剂给药后 5 至 30 分钟的时间窗，前提是 TI 已调整。 (J Am Coll Cardiol 2006;47:2027-33) (c) 2006 年，美国心脏病学会基金会。
OBJECTIVES This study sought to investigate the influence of time, dose, and inversion time (TI) and their interactions on myocardial infarct size measurements to establish the foundation for a standardized protocol for multicenter trials.BACKGROUND There is growing interest in using magnetic resonance imaging (MRI) infarct size measurements as an end point in clinical trials. However, no standardized protocol exists, and there are limited data concerning the effects of time, contrast agent dose, and TI.METHODS First, we determined the influence of postcontrast imaging time (5 to 40 min), contrast agent dose (0.1 vs. 0.2 mmol/kg), TI, and their interactions in an animal model (n = 14). Second, we tested whether the findings of the animal study apply to patients and are generalizable. Therefore, we retested the diagnostic window in a multicenter study. A total of 48 patients with first acute myocardial infarction (AMI) from three centers were imaged twice (5 and 30 min) after injection of 0.15 mmol/kg gadolinium diethylenetriamine-pentaacetate using an adjusted TI.RESULTS The animal study showed that the infarct size is independent of time and dose (p = 0.9 and p = 0.16, respectively) using an adjusted TI. Using a fixed TI, however, infarct size is a function of time and dose (p = 0.0001 and p = 0.01, respectively). The multicenter study showed that MRI 1 (16.9 +/- 12% of left ventricle) was not statistically different from MRI 2 (16.4 +/- 12% of left ventricle, p = NS) with no difference between sites (p = NS).CONCLUSIONS The AMI size can be measured with MRI using a contrast dose between 0.1 and 0.2 mmol/kg and a time window of 5 to 30 min after contrast administration, provided that the TI is adjusted. (J Am Coll Cardiol 2006;47:2027-33) (c) 2006 by the American College of Cardiology Foundation.