Direct comparison of an intravascular and an extracellular contrast agent for quantification of myocardial perfusion
Direct comparison of an intravascular and an extracellular contrast agent for quantification of myocardial perfusion
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DOI：
10.1023/a:1006368619112
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发表时间：
1999-12-01
期刊：
影响因子：
--
通讯作者：
Stillman, AE
中科院分区：
文献类型：
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作者：
Jerosch-Herold, M;Wilke, N;Stillman, AE
在左冠状动脉前降支装有限流性封堵器的猪模型(N=5)中，直接比较了细胞外和血管内造影剂对心肌血流灌注的影响。在细胞外或血管内造影剂首次通过饱和恢复TurboFLASH序列期间的快速成像显示，心肌组织区域的峰值对比度与噪声增强相似，血流在基线时平均为1.1+/-0.2，充血时为4.8+/-0.6ml/min/g。用Gadmer-17和微球血流量测量的MR血流量之间的变异系数为11+/-11，而用细胞外CA测量血流量的相应变异系数为23+/-11。血管内示踪剂观察到的静息和充血之间的血容量差异显著(V-VASc(REST)=0.078+/-0.013毫升/克，而V-VASC(充血)=0.102+/-0.019毫升/克；P<；0.05)。通过选择脉搏序列参数以提供与静息和充血之间预期变化一致的血容量估计，将水交换的影响降至最低。这项研究是首次在首次通过成像研究中应用多个指标来评估心肌灌注。使用血管内造影剂而不是细胞外造影剂可以减少组织残留物曲线建模的自由度，并提高血流估计的准确性。
A direct comparison of extracellular and intravascular contrast agents for the assessment of myocardial perfusion was carried out in a porcine model (N = 5) with a flow-limiting occluder on the left anterior descending coronary artery. Rapid imaging during the first pass of an extracellular or intravascular contrast agent with a saturation-recovery-prepared TurboFLASH sequence showed comparable peak contrast-to-noise enhancements in myocardial tissue regions with flows averaging 1.1 +/- 0.2 at baseline to 4.8 +/- 0.6 ml/min/g during hyperemia. The coefficient of variation between the MR estimates of blood flow with Gadomer-17 and the microsphere blood flow measurements was 11 +/- 11, while the corresponding coefficient of variation for blood flow estimates with the extracellular CA was 23 +/- 11. Blood volume differences between rest and hyperemia observed with the intravascular tracer were significant (V-vasc(rest) = 0.078 +/- 0.013 ml/g, versus V-vasc(hyperemia) = 0.102 +/- 0.019 ml/g; p < 0.05). The effects of water exchange were minimized through the choice of pulse sequence parameters to provide blood volume estimates consistent with the changes expected between rest and hyperemia. This study represents the first application of multiple indicators in first pass imaging studies for the assessment of myocardial perfusion. The use of an intravascular instead of an extracellular contrast agent allows a reduction of the degrees of freedom for modeling tissue residue curves and results in improved accuracy of blood flow estimates.