Measurement of Extracellular Volume and Transit Time Heterogeneity Using Contrast-Enhanced Myocardial Perfusion MRI in Patients After Acute Myocardial Infarction
Measurement of Extracellular Volume and Transit Time Heterogeneity Using Contrast-Enhanced Myocardial Perfusion MRI in Patients After Acute Myocardial Infarction
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DOI：
10.1002/mrm.26320
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发表时间：
2017-06-01
影响因子：
3.3
通讯作者：
Nekolla, Stephan G.
中科院分区：
文献类型：
--
作者：
Kunze, Karl P.;Rischpler, Christoph;Nekolla, Stephan G.
目的：评价动态增强心肌灌注MRI测量细胞外体积（ECV）的能力，探讨心肌梗死后成功血运重建患者毛细管传递时间异质性（CTH）的可能性。方法：在3特斯拉正电子发射断层扫描(PET)/MRI扫描仪上获取24组灌注数据。三种不同复杂度的灌注模型以分层方式实现，并使用Akaike信息准则来确定数据支持的拟合参数的数量。将结果与均衡T1映射方法（改进的looklocker反演恢复（MOLLI））的ECV进行了扇区比较。结果：灌注分析得出的ECV与平衡测量结果相关性良好（R-2=0.76）。16%的扇区（大多是偏远地区）支持对CTH的估计。包含非零CTH参数通常会导致较低的第一次提取估计和略高的血容量和流量估计。估算毛细管渗透率-表面积积在81%的扇区是可行的。结论：传递时间异质性对心肌灌注MRI数据的动力学分析具有可测量的影响，Gd-DTPA在心肌中的外渗在梗死相关病理中通常不受血流限制。使用灌注成像测量心肌ECV可以为基于T-1制图的方法提供扫描时间效率的替代方法。(C) 2016国际医学磁共振学会
Purpose: To assess the ability of dynamic contrast-enhanced myocardial perfusion MRI to measure extracellular volume (ECV) and to investigate the possibility of estimating capillary transit time heterogeneity (CTH) in patients after myocardial infarction and successful revascularization.Methods: Twenty-four perfusion data sets were acquired on a 3 Tesla positron emission tomography (PET)/MRI scanner. Three perfusion models of different complexity were implemented in a hierarchical fashion with an Akaike information criterion being used to determine the number of fit parameters supported by the data. Results were compared sector-wise to ECV from an equilibrium T1 mapping method (modified looklocker inversion recovery (MOLLI)).Results: ECV derived from the perfusion analysis correlated well with equilibrium measurements (R-2=0.76). Estimation of CTH was supported in 16% of sectors (mostly remote). Inclusion of a nonzero CTH parameter usually led to lower estimates of first-pass extraction and slightly higher estimates of blood volume and flow. Estimation of the capillary permeability-surface area product was feasible in 81% of sectors.Conclusion: Transit time heterogeneity has a measurable effect on the kinetic analysis of myocardial perfusion MRI data, and Gd-DTPA extravasation in the myocardium is usually not flow-limited in infarct-related pathology. Measurement of myocardial ECV using perfusion imaging could provide a scantime efficient alternative to methods based on T-1 mapping. (C) 2016 International Society for Magnetic Resonance in Medicine