Editorial for "Impact of Wideband Late Gadolinium Enhancement Cardiac Magnetic Resonance Imaging on Device-Related Artifacts in Different Implantable Cardioverter-Defibrillator Types"
Editorial for "Impact of Wideband Late Gadolinium Enhancement Cardiac Magnetic Resonance Imaging on Device-Related Artifacts in Different Implantable Cardioverter-Defibrillator Types"
复制标题
“宽带晚期钆增强心脏磁共振成像对不同植入式心脏复律除颤器类型中设备相关伪影的影响”的社论
DOI：
10.1002/jmri.27777
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发表时间：
2021
影响因子：
4.4
通讯作者：
Huang L
中科院分区：
文献类型：
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作者：
Huang L
无创评估多种心血管疾病中存在的心肌纤维化和/或瘢痕的存在及其特征对临床诊断和预后具有重要意义。晚期钆增强（LGE）是一种心脏MRI技术，被认为是无创评估心肌纤维化和/或疤痕的金标准。1,2该技术基于缩短t1的钆造影剂，由于组织中细胞外体积的变化，相对于健康心肌，该造影剂将在纤维化/疤痕区域经历延迟摄取冲洗。LGE序列通常采用反转恢复成像方案，在大量注射造影剂后10-20分钟进行，在纤维化/疤痕区域产生信号高信号，在健康心肌中产生信号零。由于存在严重的伪影，LGE技术在非核磁共振条件植入式心脏装置（例如，非核磁共振条件植入式心律转复除颤器（ICD））患者中的应用仍然有限。这些伪影是由器件引起的频移引起的，这会导致非共振落在反演准备和成像带宽之外。Rashid等人已经提出使用宽带（WB）反转来成功地减少这些伪影。大多数关于ICD的WB LGE研究都集中在传统的经静脉ICD （TV-ICD）上。其他ICD亚型，包括心脏再同步化治疗除颤器（CRT-D）和皮下ICD (S-ICD)，在过去的几十年里使用越来越多，但仍然缺乏相应的研究。
It is clinically important for diagnosis and prognosis to non-invasively assess the presence and characteristics of myocardial fibrosis and/or scar existing in a variety of cardiovascular diseases. Late Gadolinium Enhancement (LGE) is a cardiac MRI technique, which is considered as the gold standard for the non-invasive assessment of myocardial fibrosis and/or scar. 1, 2 This technique is based on a T1-shortening Gadolinium-based contrast agent, which will experience delayed uptake-washout in areas of fibrosis/scar with respect to healthy myocardium due to the change of extra-cellular volume in tissue. LGE sequence commonly uses an inversion recovery imaging scheme and is performed 10–20 minutes after a bolus injection of the contrast agent, yielding signal hyperintensity in areas of fibrosis/scar as well as signal nulling in healthy myocardium.LGE technique remains limited in patients with non-MR-conditional implantable cardiac device, for example, non-MR-conditional implantable cardioverter-defibrillator (ICD), due to the presence of severe artifacts. These artifacts are caused by the device-induced frequency shift, which results in off-resonance falling outside of the inversion preparation and imaging bandwidths. The use of wideband (WB) inversion has been proposed by Rashid et al to successfully reduce these artifacts. 3 Most of WB LGE studies on ICD have focused on traditional transvenous ICD (TV-ICD). Corresponding investigations on other ICD subtypes including cardiac resynchronization therapy defibrillator (CRT-D) and subcutaneous ICD (S-ICD), which have growing usage in the last decades, are still lacking.