Determinants of myocardial response in CMR perfusion imaging using Gd-BOPTA (Multihance®)
Determinants of myocardial response in CMR perfusion imaging using Gd-BOPTA (Multihance®)
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DOI：
10.1081/jcmr-200060647
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发表时间：
2005-01-01
影响因子：
6.4
通讯作者：
Nagel, E
中科院分区：
文献类型：
--
作者：
Gebker, R;Paetsch, I;Nagel, E
目的。不同的中心和供应商使用不同的序列和造影剂应用方案进行MR心肌灌注成像。本研究的目的是评估不同序列、剂量和注射速度的造影剂在半定量MR灌注评估中的作用。方法：研究方法。在一项对58名连续患者进行的先导性研究中，比较了三种最常用的磁共振心肌灌注成像序列(T1-GRE、GRE-EPI或SSFP)在峰值心肌增强和图像质量方面的差异。在研究的主要部分，24名患者在外周静脉注射后，使用先导研究中最有利的序列(SSFP)进行了动态首过MR灌注成像(飞利浦Intera CV，荷兰Best)。腺苷应激时Gd-BOPTA的应用。采用两种剂量(0.05mmolkgbw和0.025 mmolkgbw)和4种不同注射速度(8、4、3、2ml/S)。测定了正常冠脉供血的LV和心肌节段的信号强度-时间曲线，并注意到IV与心肌上斜率和峰值强化的相关性。结果。当Gd-BOPTA剂量为0.05 mmol/kgbw时，SSFP序列表现出较高的峰值增强，且两种剂量方案的图像质量均优于其他序列，因此被应用于主要研究。左心室和心肌的上斜率之间存在显著的相关性(r平方=0.85p<；0.001)。然而，LV和心肌上斜率基本上与剂量无关。在注射速率为2ml/S时，心肌的上行速度明显慢于3ml/S和4ml/S。剂量越大，心肌的强化越明显(p<；0.001)。结论。在健康心肌节段，心肌上斜率主要由LV上斜率决定。只要注射速度不低于3ml/S，心肌增强和上斜率在很大程度上与注射造影剂的速度无关。然而，心肌增强是剂量依赖的。因此，对LV上斜率的简单校正允许对各种输入参数进行归一化。校正后心肌上行信号强度或峰值信号强度的差异应主要取决于血流。
Purpose. Different centers and vendors use different sequences and contrast agent application schemes for MR myocardial perfusion imaging. The purpose of this study was to evaluate the role of different sequences, dosages, and injection speeds of contrast media for semiquantitative MR-perfusion assessment. Methods. In a pilot study with 58 consecutive patients three of the most commonly used sequences for MR myocardial perfusion imaging (T1-GrE, GrE-EPI or SSFP) were compared to each other in terms of peak myocardial enhancement and image quality. For the main part of the study dynamic first pass MR perfusion imaging (Philips Intera CV, Best, the Netherlands) was performed in 24 patients using the most favorable sequence from the pilot study (SSFP) after peripheral i.v. administration of Gd-BOPTA during adenosine stress. Two doses (0.05 mmol/kg bw and 0.025 mmol/kg bw) and four different injection speeds (8, 4, 3, 2 ml/s) were used. Signal intensity time curves were determined in the LV and myocardial segments supplied by normal coronary arteries and correlation between IV and myocardial upslope as well as peak enhancement were noted. Results. The SSFP-sequence showed a higher peak enhancement when using 0.05 mmol/kg bw of Gd-BOPTA and a superior image quality for both dosage regimen compared with the other sequences and was consequently applied for the main study. A significant correlation was found between the upslopes in the LV and the myocardium (r square = 0.85, p < 0.001). However, LV and myocardial upslopes were largely independent of the dosage. Myocardial upslope was significantly slower at an injection rate of 2 ml/s compared to 3 and 4 ml/s. Higher Gd-doses led to significantly higher enhancement (p < 0.001). Conclusion. In healthy myocardial segments, the myocardial upslope is mainly determined from the LV upslope. Both myocardial enhancement and upslope are largely independent from the injection rate of a contrast agent bolus as long as the injection speed is not below 3 ml/s. Myocardial enhancement, however, is dose dependent. Thus, a simple correction for LV upslope allows to normalize a wide variety of input parameters. Differences of myocardial upslope or peak signal intensity after correction should be mainly dependent on blood flow.