Native T1 Mapping by 3-T CMR Imaging for Characterization of Chronic Myocardial Infarctions
Native T1 Mapping by 3-T CMR Imaging for Characterization of Chronic Myocardial Infarctions
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DOI：
10.1016/j.jcmg.2015.04.018
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发表时间：
2015-09-01
影响因子：
14
通讯作者：
Dharmakumar, Rohan
中科院分区：
文献类型：
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作者：
Kali, Avinash;Choi, Eui-Young;Dharmakumar, Rohan
目的 本研究的目的是探讨 3-T 的天然 T-1 图是否能够可靠地表征既往 ST 段抬高型心肌梗死 (STEMI) 或非 ST 段抬高型心肌梗死 (NSTEMI) 患者的慢性心肌梗死 (MI)。 背景 晚期钆增强 (LGE) 心脏磁共振是表征慢性 MI 的黄金标准，但在患有以下疾病的患者中是禁忌的方法 在 MI 后中位 13.6 年时，既往 STEMI (n =13) 和 NSTEMI (n =12) 患者在 3-T 时获取原生 T-1 和 LGE 图像。使用 LGE 图像和 T-1 图的平均值 +/- 5 SD 阈值标准测量梗塞位置、大小和透壁性，并相互比较。独立评审员评估了 LGE 图像和 T-1 图上 MI 的视觉显着性。结果 使用阈值标准测量梗死面积（STEMI：p = 0.46；NSTEMI：p = 0.27）和透壁性（STEMI：p = 0.13；NSTEMI：p = 0.21）时，原生 T-1 图和 LGE 图像没有差异。使用阈值标准，LGE 图像和 T-1 图之间观察到测量梗塞大小（STEMI：偏差 = 0.6 +/- 3.1%；R-2 = 0.93；NSTEMI：偏差 = -0.4 +/- 4.4%；R-2 = 0.85）和透壁性（STEMI：偏差 = 2.0 +/- 4.2%；R-2 = 0.89；NSTEMI：偏差 = -2.7 +/- 7.9%；R-2 = 0.68)。基于阈值标准检测慢性 Mls 的 T-1 图谱的敏感性和特异性分别为 89% 和 98% (STEMI)，以及 (NSTEMI) 分别为 87% 和 95%。相对于 LGE 图像，T-1 地图检测慢性 Mls 的平均视觉显着性评分显着较低（两种情况下 p < 0.001）。相对于 T-1 图，LGE 图像的中位梗塞与远端心肌对比度噪声比高 2.5 倍 (p < 0.001)。用于视觉检测的 T-1 图谱的敏感性和特异性分别为 60% 和 86% (STEMI)，以及 64% 和 91% (NSTEMI)。结论 STEMI 和 NSTEMI 患者的慢性 Mls 可以使用 3-T 时天然 T-1 图谱上基于阈值的检测来可靠地表征。在两个患者群体的天然 T-1 图上对慢性 MLS 进行目视检测具有较高的特异性，但敏感性较低。 (C) 2015 年，美国心脏病学会基金会。
OBJECTIVES The purpose of this study was to investigate whether native T-1 maps at 3-T can reliably characterize chronic myocardial infarctions (MIs) in patients with prior ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI).BACKGROUND Late gadolinium enhancement (LGE) cardiac magnetic resonance is the gold standard for characterizing chronic MIs, but it is contraindicated in patients with end-stage chronic kidney disease.METHODS Native T-1 and LGE images were acquired at 3-T in patients with prior STEMI (n =13) and NSTEMI (n =12) at a median of 13.6 years post-MI. Infarct Location, size, and transmurality were measured using mean +/- 5 SDs thresholding criterion from LGE images and T-1 maps and compared against one another. Independent reviewers assessed visual conspicuity of MIs on LGE images and T-1 maps.RESULTS Native T-1 maps and LGE images were not different for measuring infarct size (STEMI: p = 0.46; NSTEMI: p = 0.27) and transmurality (STEMI: p = 0.13; NSTEMI: p = 0.21) using thresholding criterion. Using thresholding criterion, good agreement was observed between LGE images and T-1 maps for measuring infarct size (STEMI: bias = 0.6 +/- 3.1%; R-2 = 0.93; NSTEMI: bias = -0.4 +/- 4.4%; R-2 = 0.85) and transmurality (STEMI: bias = 2.0 +/- 4.2%; R-2 = 0.89; NSTEMI: bias = -2.7 +/- 7.9%; R-2 = 0.68). Sensitivity and specificity of T-1 maps for detecting chronic Mls based on thresholding criterion were 89% and 98%, respectively (STEMI), and 87% and 95%, respectively (NSTEMI). Relative to LGE images, the mean visual conspicuity score for detecting chronic Mls was significantly Lower for T-1 maps (p < 0.001 for both cases). Median infarct-to-remote myocardium contrast-to-noise ratio was 2.5-fold higher for LGE images relative to T-1 maps (p < 0.001). Sensitivity and specificity of T-1 maps for visual detection were 60% and 86%, respectively (STEMI), and 64% and 91% (NSTEMI), respectively.CONCLUSIONS Chronic Mls in STEMI and NSTEMI patients can be reliably characterized using threshold-based detection on native T-1 maps at 3-T. Visual detection of chronic Mls on native T-1 maps in both patient populations has high specificity, but modest sensitivity. (C) 2015 by the American College of Cardiology Foundation.