Quantitative analysis of late gadolinium enhancement in hypertrophic cardiomyopathy: comparison of diagnostic performance in myocardial fibrosis between gadobutrol and gadopentetate dimeglumine
Quantitative analysis of late gadolinium enhancement in hypertrophic cardiomyopathy: comparison of diagnostic performance in myocardial fibrosis between gadobutrol and gadopentetate dimeglumine
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DOI：
10.1007/s10554-017-1101-7
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发表时间：
2017-08-01
影响因子：
2.1
通讯作者：
Fan, Zhanming
中科院分区：
文献类型：
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作者：
Liu, Dongting;Ma, Xiaohai;Fan, Zhanming
本研究的目的是比较不同的半自动化晚期钆增强（LGE）定量技术在肥厚性心肌病（HCM）患者中使用加多比特和加多戊二胺造影剂诊断纤维化心肌的价值。30例HCM患者接受了两次心脏MRI检查，使用了加多比特和加多戊二胺。比较LGE区与远端心肌（CNRremote）、LGE区与左室血池（CNRpool）的比噪比（CNR）和LGE的信噪比（SNR）。目测法测定LGE的存在和数量。基于信号阈值与参考均值（STRM）的阈值分别比参考心肌的平均信号强度（SI）高2、5、6个SD，采用半最大全宽（FWHM）技术。比较两种造影剂对LGE面积的影响。在两种方案中，30例患者中有26例（86.6%）存在LGE。加多比特和加多戊二胺组纤维化心肌的CNRremote分别为26.82 +/- 14.24和21.46 +/- 10.59 （P < 0.05）。加多比诺组CNRpool显著增高（9.32 +/- 7.64 vs. 6.39 +/- 6.11, P < 0.05）。加多比特组信噪比更高（33.36 +/- 14.35 vs. 27.53 +/- 10.91, P < 0.05）。gadobutrol组的MR图像中瘢痕体积明显高于gadobutrol组（P < 0.05）， 5 SD技术的STRM与视觉评价的一致性最高（ICC = 0.99）。LGE区纤维化心肌的纤维化节段差异无统计学意义（P < 0.05）。本研究证明，加多比特是一种有效的LGE造影剂，与加多比特二聚氨基胍相比，它对纤维化心肌的描绘更清晰。5sd技术产生的LGE范围最接近于通过视觉评估确定的LGE范围。
The purpose of this study was to compare different semi-automated late gadolinium enhancement (LGE) quantification techniques using gadobutrol and gadopentetate dimeglumine contrast agents with regard to the diagnosis of fibrotic myocardium in patients with hypertrophic cardiomyopathy (HCM). Thirty patients with HCM underwent two cardiac MRI protocols with use of gadobutrol and gadopentetate dimeglumine. Contrast-to-noise ratio (CNR) between LGE area and remote myocardium (CNRremote), between LGE area and left ventricular blood pool (CNRpool), and signal-to-noise ratio (SNR) in LGE were compared. The presence and quantity of LGE were determined by visual assessment. With signal threshold versus reference mean (STRM) based thresholds of 2 SD, 5 SD, and 6 SD above the mean signal intensity (SI) of reference myocardium, the full-width at half-maximum (FWHM) technique was used. The volume and segments of the LGE area were compared between the two types of contrast agents. LGE was present in 26 of 30 (86.6%) patients in both protocols. The CNRremote of fibrotic myocardium in gadobutrol and gadopentetate dimeglumine agents was 26.82 +/- 14.24 and 21.46 +/- 10.59, respectively (P < 0.05). The CNRpool was significantly higher in gadobutrol (9.32 +/- 7.64 vs. 6.39 +/- 6.11, P < 0.05). The SNR was higher in gadobutrol (33.36 +/- 14.35 vs. 27.53 +/- 10.91, P < 0.05). The volume of scar size in MR images acquired with gadobutrol were significantly higher than those with gadopentetate dimeglumine (P < 0.05), and the STRM of 5 SD technique showed the greatest agreement with visual assessment (ICC = 0.99) in both examinations. There was no significant difference in fibrotic segments of the fibrotic myocardium in the LGE area (P < 0.05). This study proved that the Gadobutrol was an effective contrast agent for LGE imaging with superior delineation of fibrotic myocardium as compared to gadopentetate dimeglumine. The 5 SD technique yields the closest approximation of the extent of LGE identified by visual assessment.