Verification of threshold for image intensity ratio analyses of late gadolinium enhancement magnetic resonance imaging of left atrial fibrosis in 1.5T scans
Verification of threshold for image intensity ratio analyses of late gadolinium enhancement magnetic resonance imaging of left atrial fibrosis in 1.5T scans
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DOI：
10.1007/s10554-019-01728-0
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发表时间：
2020-03-01
影响因子：
2.1
通讯作者：
Svendsen, Jesper Hastrup
中科院分区：
文献类型：
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作者：
Bertelsen, Litten;Alarcon, Francisco;Svendsen, Jesper Hastrup
心血管磁共振成像左心房晚期钆增强（LA LGE）用于纤维化评估的使用越来越多，尽管由于复杂的图像采集和图像分析缺乏共识，其使用仍然局限于专门的中心。利用图像强度比（IIR）（血池强度归一化心房壁像素强度）分析LA LGE，为获得心房纤维化定量数据提供了一种客观的方法。在3T扫描中，健康心肌和纤维化之间的阈值为1.2。这项研究的目的是在1.5T扫描中确认这个阈值。采用1.5T磁共振扫描仪对11例单独房颤患者、11例年龄匹配的健康志愿者（27-44岁）和11例无房颤病史但不同程度合并症的老年患者进行LA LGE。所有健康志愿者的IIR平均值+2SD作为正态性上限，并复制为1.21，维持原始的IIR阈值1.20。独居房颤患者的纤维化程度[中位数9.0% (IQR 3.9-12.0)]高于健康志愿者[2.8%(1.3-8.3)]，老年非房颤患者的纤维化程度更高[20.1% (10.2-35.8),p = 0.001]。先前建立的iir阈值为1.2，在1.5T LA LGE扫描中得到重申。单发房颤患者心房纤维化程度高于同年龄段的健康志愿者。无房颤史的老年患者与两组年轻患者相比，纤维化程度明显更高。
The use of cardiovascular magnetic resonance imaging left atrial late gadolinium enhancement (LA LGE) is increasing for fibrosis evaluation though the use is still limited to specialized centres due to complex image acquisition and lack of consensus on image analyses. Analysis of LA LGE with image intensity ratio (IIR) (pixel intensity of atrial wall normalized by blood pool intensity) provides an objective method to obtain quantitative data on atrial fibrosis. A threshold between healthy myocardium and fibrosis of 1.2 has previously been established in 3T scans. The aim of the study was to reaffirm this threshold in 1.5T scans. LA LGE was performed using a 1.5T magnetic resonance scanner on: 11 lone-AF patients, 11 age-matched healthy volunteers (aged 27-44) and 11 elderly patients without known history of AF but varying degrees of comorbidities. Mean values of IIR for all healthy volunteers +2SD were set as upper limit of normality and was reproduced to 1.21 and the original IIR-threshold of 1.20 was maintained. The degree of fibrosis in lone-AF patients [median 9.0% (IQR 3.9-12.0)] was higher than in healthy volunteers [2.8% (1.3-8.3)] and even higher in elderly non-AF [20.1% (10.2-35.8), p = 0.001]. The previously established IIR-threshold of 1.2 was reaffirmed in 1.5T LA LGE scans. Patients with lone AF presented with increased degrees of atrial fibrosis compared to healthy volunteers in the same age-range. Elderly patients with no history of AF showed significantly higher degrees of fibrosis compared to both groups with younger individuals.