Detection of pulmonary vein and left atrial scar after catheter ablation with three-dimensional navigator-gated delayed enhancement MR imaging: Initial experience
Detection of pulmonary vein and left atrial scar after catheter ablation with three-dimensional navigator-gated delayed enhancement MR imaging: Initial experience
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DOI：
10.1148/radiol.2433060417
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发表时间：
2007-06-01
期刊：
影响因子：
19.7
通讯作者：
Manning, Warren J.
中科院分区：
文献类型：
--
作者：
Peters, Dana C.;Wylie, John V.;Manning, Warren J.
目的：前瞻性评价高空间分辨率延迟增强磁共振成像（MR）能否显示房颤患者左心房射频消融（RF）后的瘢痕。（16名男性，7名女性;平均年龄，54岁+/- 13岁[标准差]）提供了书面知情同意书;该研究得到了当地机构审查委员会的批准，符合HIPAA。开发了一种高空间分辨率的自由呼吸延迟增强MR成像方法，用于检测LA和肺静脉（PV）中的瘢痕（即消融组织）。检查了15例消融前和18例消融后至少30天的左心房。一名有4年经验的阅片师评估了图像上延迟增强的存在和周向完整性。测量信噪比和对比度噪声比，并采用非配对t检验进行比较。测量增强厚度在房间隔和消融后的天数之间的关系investigated.Results：没有主题表现出消融前延迟增强的心房或PV壁，而消融后延迟增强被确定在所有（100%）。在消融术后的患者中，左下肺静脉可识别出部分至完全周向延迟增强模式，包括88% +/- 11周向，但只有62%的患者表现出超过90%的周向延迟增强。血液的信噪比为12，消融前后左房壁的信噪比分别为15和22（P <0.05）。延迟增强壁厚与消融时间间隔倒数之间的关系被确定（P <0.05）。结论：高空间分辨率延迟增强MR成像允许无创识别肺静脉隔离治疗后射频消融引起的瘢痕。(c)RSNA，2007年。
Purpose: To prospectively evaluate whether scar caused by radio-frequency ( RF) ablation of the left atrium ( LA) in patients with atrial fibrillation can be depicted with high-spatial-resolution delayed enhancement magnetic resonance ( MR) imaging.Materials and Methods: All 23 subjects ( 16 men, seven women; mean age, 54 years +/- 13 [ standard deviation]) provided written informed consent; the study was approved by the local institutional review board and was HIPAA compliant. A high-spatial-resolution free-breathing delayed enhancement MR imaging method was developed to detect scar ( ie, ablated tissue) in the LA and pulmonary veins ( PVs). The LA in 15 patients before ablation and in 18 patients at least 30 days after ablation was examined. A reader with 4 years of experience assessed presence of delayed enhancement on images and circumferential completeness. Signal-to-noise and contrast-to-noise ratios were measured and compared with an unpaired t test. The relationship between measurements of enhancement thickness at the interatrial septum and the number of days after ablation was investigated.Results: No subject demonstrated preablation delayed enhancement of the atrial or PV wall, whereas postablation delayed enhancement was identified in all ( 100%). In patients after ablation, a partial to completely circumferential delayed enhancement pattern could be identified for the left inferior PV that encompassed 88% +/- 11 of the circumference, but only 62% of patients demonstrated more than 90% circumferential delayed enhancement. The signal-to-noise ratio of blood was 12, and the signal-to-noise ratios of the pre- and postablation left atrial wall were 15 and 22, respectively ( P < .05). A relationship between delayed enhancement wall thickness and the inverse of the time interval from ablation was identified ( P < .05).Conclusion: High-spatial-resolution delayed enhancement MR imaging allows noninvasive identification of scar induced by RF ablation following isolation therapy of the PV. (c) RSNA, 2007.