Fully quantitative pixel-wise analysis of cardiovascular magnetic resonance perfusion improves discrimination of dark rim artifact from perfusion defects associated with epicardial coronary stenosis.
Fully quantitative pixel-wise analysis of cardiovascular magnetic resonance perfusion improves discrimination of dark rim artifact from perfusion defects associated with epicardial coronary stenosis.
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DOI：
10.1186/s12968-018-0436-0
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发表时间：
2018-03-08
期刊：
影响因子：
--
通讯作者：
Arai AE
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文献类型：
--
作者：
Ta AD;Hsu LY;Conn HM;Winkler S;Greve AM;Shanbhag SM;Chen MY;Patricia Bandettini W;Arai AE
首过心血管磁共振 (CMR) 灌注图像中的暗边伪影可能会模拟灌注缺陷，并影响冠状动脉疾病 (CAD) 的诊断准确性。我们评估了定量心肌血流 (MBF) 是否可以区分 CMR 灌注中的暗边缘伪影和真正的灌注缺陷。对 76 名患者进行了 1.5 T 的 Regadenoson 灌注 CMR。显着的 CAD 是通过定量侵入性冠状动脉造影 (QCA) ≥50% 直径狭窄来定义的。非显着 CAD (NonCAD) 定义为所有主要心外膜动脉中 QCA 直径狭窄 < 50% 或计算机断层扫描冠状动脉造影 (CTA) < 30%。出于比较目的，暗边伪影研究了特定的和基于指南的定义。 MBF 在像素级和扇区级进行量化。在具有暗边缘伪影的 NonCAD 亚组中，心内膜下层的应力 MBF 低于心肌中层和心外膜层（2.17±±0.61 vs. 3.06±±0.75 vs. 3.24±±0.80 mL/min/g，均 p<±0.001），并且也是 30%低于偏远地区（2.17 ± 0.61 vs. 2.83 ± 0.67 mL/min/g，p< 0.001）。然而，暗缘伪影中的心内膜下应力 MBF 比真实灌注缺陷高 37-56%（2.17±0.61 vs. 0.95±0.43 mL/min/g，p<0.001）。绝对应力 MBF 使用像素级分析区分 CAD 和 NonCAD，准确度范围为 86% 至 89%（所有 p< 0.001）。部门层面也出现了类似的结果。暗边缘伪影中的定量应力 MBF 低于远端心肌，但显着高于真正的灌注缺陷。如果在更大的系列中得到证实，这种方法可能有助于解释临床应激灌注检查。 ClinicalTrials.gov 标识符：NCT00027170；首次发布于 2001 年 11 月 28 日；更新于 2017 年 11 月 27 日。
Dark rim artifacts in first-pass cardiovascular magnetic resonance (CMR) perfusion images can mimic perfusion defects and affect diagnostic accuracy for coronary artery disease (CAD). We evaluated whether quantitative myocardial blood flow (MBF) can differentiate dark rim artifacts from true perfusion defects in CMR perfusion. Regadenoson perfusion CMR was performed at 1.5 T in 76 patients. Significant CAD was defined by quantitative invasive coronary angiography (QCA) ≥ 50% diameter stenosis. Non-significant CAD (NonCAD) was defined as stenosis by QCA < 50% diameter stenosis or computed tomographic coronary angiography (CTA) < 30% in all major epicardial arteries. Dark rim artifacts had study specific and guideline-based definitions for comparison purposes. MBF was quantified at the pixel-level and sector-level. In a NonCAD subgroup with dark rim artifacts, stress MBF was lower in the subendocardial than midmyocardial and epicardial layers (2.17 ± 0.61 vs. 3.06 ± 0.75 vs. 3.24 ± 0.80 mL/min/g, both p < 0.001) and was also 30% lower than in remote regions (2.17 ± 0.61 vs. 2.83 ± 0.67 mL/min/g, p < 0.001). However, subendocardial stress MBF in dark rim artifacts was 37–56% higher than in true perfusion defects (2.17 ± 0.61 vs. 0.95 ± 0.43 mL/min/g, p < 0.001). Absolute stress MBF differentiated CAD from NonCAD with an accuracy ranging from 86 to 89% (all p < 0.001) using pixel-level analyses. Similar results were seen at a sector level. Quantitative stress MBF is lower in dark rim artifacts than remote myocardium but significantly higher than in true perfusion defects. If confirmed in larger series, this approach may aid the interpretation of clinical stress perfusion exams. ClinicalTrials.gov Identifier: NCT00027170; first posted 11/28/2001; updated 11/27/2017.
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影响因子：
14
作者：
Hsu, Li-Yueh;Groves, Daniel W.;Aletras, Anthony H.;Kellman, Peter;Arai, Andrew E.
通讯作者：
Arai, Andrew E.
影响因子：
14
作者：
Mordini, Federico E.;Haddad, Tariq;Hsu, Li-Yueh;Kellrnan, Peter;Lowrey, Tracy B.;Aletras, Anthony H.;Bandettini, Patricia;Arai, Andrew E.
通讯作者：
Arai, Andrew E.
影响因子：
3.3
作者：
Meloni, Antonella;Al-Saadi, Nidal;Lombardi, Massimo
通讯作者：
Lombardi, Massimo
影响因子：
24
作者：
Jaarsma, Caroline;Leiner, Tim;Schalla, Simon
通讯作者：
Schalla, Simon
影响因子：
4.4
作者：
Hsu, LY;Rhoads, KL;Arai, AE
通讯作者：
Arai, AE