A quantitative pixel-wise measurement of myocardial blood flow by contrast-enhanced first-pass CMR perfusion imaging: microsphere validation in dogs and feasibility study in humans.
A quantitative pixel-wise measurement of myocardial blood flow by contrast-enhanced first-pass CMR perfusion imaging: microsphere validation in dogs and feasibility study in humans.
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DOI：
10.1016/j.jcmg.2011.07.013
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发表时间：
2012-02
影响因子：
14
通讯作者：
Arai, Andrew E.
中科院分区：
文献类型：
--
作者：
Hsu, Li-Yueh;Groves, Daniel W.;Aletras, Anthony H.;Kellman, Peter;Arai, Andrew E.
本研究的目的是基于对比增强的首过心脏磁共振（CMR）成像在像素水平上评价犬和患者的完全定量心肌血流量（MBF）。微球可以量化亚克级感兴趣区域的MBF，但CMR灌注成像可能能够量化MBF并以更高的分辨率区分血流。在冠状动脉内腺苷诱导局部充血的狗模型中进行了首次通过CMR灌注成像。荧光微球是MBF验证的参考标准。对有创性冠状动脉造影发现的严重冠状动脉疾病（CAD）患者进行CMR灌注成像。图像的心肌时间-信号强度曲线使用模型约束的去卷积分析在逐像素的基础上进行量化。在所有动物中，定性、彩色CMR灌注像素图与微球MBF靶心图相当。逐像素CMR MBF估计值与亚克（0.49 ± 0.14 g）微球测量值相关良好（r=0.87至0.90），但显示MBF的轻微低估。为了减少由于配准错误引起的偏倚并最大限度地减少与重复测量相关的问题，将每只动物的一个充血和一个远程扇区与微球MBF进行比较，这改善了相关性（r=0.97至0.98），偏倚接近于零。扇区方式和像素方式CMR MBF估计也相关良好（r=0.97）。在患者中，彩色CMR负荷灌注像素图显示狭窄冠状动脉区域的局部血流减少和透壁灌注梯度。心内膜与心外膜亚区以及缺血与远端亚区的MBF估计值均存在显著差异（p<0.001和p<0.01）。心肌血流可以在CMR灌注图像上以像素水平（约32微升心肌）进行量化，并且结果与微球测量结果进行了很好的比较。高分辨率逐像素CMR灌注图可以量化CAD患者的透壁灌注梯度。
The aim of this study was to evaluate fully quantitative myocardial blood flow (MBF) at a pixel level based on contrast-enhanced first-pass cardiac magnetic resonance (CMR) imaging in dogs and patients. Microspheres can quantify MBF in subgram regions of interest but CMR perfusion imaging may be able to quantify MBF and differentiate blood flow at much higher resolution. First-pass CMR perfusion imaging was performed in a dog model with local hyperemia induced by intracoronary adenosine. Fluorescent microspheres were the reference standard for MBF validation. CMR perfusion imaging was also performed on patients with significant coronary artery disease (CAD) by invasive coronary angiography. Myocardial time-signal intensity curves of the images were quantified on a pixel-by-pixel basis using a model-constrained deconvolution analysis. Qualitatively, color CMR perfusion pixel maps were comparable to microsphere MBF bull’s-eye plots in all animals. Pixel-wise CMR MBF estimates correlated well against subgram (0.49 ± 0.14 g) microsphere measurements (r=0.87 to 0.90) but showed minor underestimation of MBF. To reduce bias due to misregistration and minimize issues related to repeated measures, one hyperemic and one remote sector per animal were compared to the microsphere MBF which improved the correlation (r=0.97 to 0.98) and the bias was close to zero. Sector-wise and pixel-wise CMR MBF estimates also correlated well (r=0.97). In patients, color CMR stress perfusion pixel maps showed regional blood flow decreases and transmural perfusion gradients in territories served by stenotic coronary arteries. MBF estimates in endocardial versus epicardial subsectors, and ischemic versus remote sectors, were all significantly different (p<0.001 and p<0.01). Myocardial blood flow can be quantified at the pixel level (~32 microliters of myocardium) on CMR perfusion images and results compared well with microsphere measurements. High-resolution pixel-wise CMR perfusion maps can quantify transmural perfusion gradients in patients with CAD.
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影响因子：
4.4
作者：
Christian, Timothy F.;Aletras, Anthony H.;Arai, Andrew E.
通讯作者：
Arai, Andrew E.
影响因子：
4.4
作者：
Hsu, LY;Rhoads, KL;Arai, AE
通讯作者：
Arai, AE
影响因子：
20.1
作者：
BASSINGTHWAIGHTE, JB;KING, RB;ROGER, SA
通讯作者：
ROGER, SA
影响因子：
20.1
作者：
BASSINGTHWAIGHTE, JB;MALONE, MA;KROHN, KA
通讯作者：
KROHN, KA
DOI：
10.1023/a:1006368619112
发表时间：
1999-12-01
期刊：
INTERNATIONAL JOURNAL OF CARDIAC IMAGING
影响因子：
--
作者：
Jerosch-Herold, M;Wilke, N;Stillman, AE
通讯作者：
Stillman, AE