Multicenter Study on the Diagnostic Performance of Native-T1 Cardiac Magnetic Resonance of Chronic Myocardial Infarctions at 3T
Multicenter Study on the Diagnostic Performance of Native-T1 Cardiac Magnetic Resonance of Chronic Myocardial Infarctions at 3T
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3T Native-T1 心脏磁共振对慢性心肌梗死诊断性能的多中心研究
DOI：
10.1161/circimaging.119.009894
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发表时间：
2020-06
期刊：
影响因子：
--
通讯作者：
Rohan Dharmakumar
中科院分区：
文献类型：
--
作者：
Guan Wang;Sang-Eun Lee;Qi Yang;Mourad Tighiouart;Jeremy Collins;Suraj Patel;Ivan Cokic;Vignesh Sadras;Daniel S Berman;Avinash Kali;Hsin-Jung Yang;Behzad Sharif;Guoxi Xie;Debiao Li;Hyuk-Jae Chang;Rohan Dharmakumar
补充数字内容可在文本中找到。背景资料：临床前研究和试点患者研究表明，慢性梗死可以通过心脏磁共振检测和表征，而无需使用基于钆的造影剂，使用3 T的天然T1标测图。我们的目的是调查这种方法的诊断能力，在多中心的设置为特征的慢性心肌梗死（MI）。研究方法：在3个不同的医疗中心招募了既往MI患者（n=105），并在3 T下进行了自然T1标测和晚期钆增强（LGE）成像。CT的位置、大小和透壁性由T1图和LGE确定。相对于LGE，评估了灵敏度、特异性、接受者操作特征指标以及观察者间和观察者内变异性。结果如下：在所有受试者中，MI区域的T1为1621±110 ms，远端区域为1225±75 ms。相对于LGE，基于本地T1标测检测MI位置的灵敏度、特异性和曲线下面积分别为88%、92%和0.93。Native-T1标测图在测量梗死面积方面无差异（Native-T1标测图：12.1±7.5%; LGE：11.8± 7.2%，P=0.82），与LGE一致（R2=0.92，偏倚，0.09±2.6%）。相应的观察者间和观察者内评估也高度相关（观察者间：R2=0.90，偏倚，0.18±2.4%;观察者内：R2=0.91，偏倚，0.28±2.1%）。天然T1图在测量MI透壁性方面无差异（天然T1图：49.1±15.8%; LGE：47.2± 19.0%，P=0.56），并显示一致性（R2=0.71;偏倚，1.32±10.2%）。相应的观察者间和观察者内评估也一致（观察者间：R2=0.81，偏倚0.1±9.4%;观察者内：R2=0.91，偏倚0.28± 2.1%）。虽然在3 T下使用本地T1图检测MI的总体准确性很高，但逻辑回归分析显示MI位置是一个突出的混杂因素。结论：Native-T1标测可用于高准确度的慢性MI成像，因此，它是禁忌LGE的慢性MI患者瘢痕成像的可行替代方案。可能需要技术进步来克服成像混杂因素，这些因素目前限制了天然T1映射达到与LGE相同的检测水平。
Supplemental Digital Content is available in the text. Background: Preclinical studies and pilot patient studies have shown that chronic infarctions can be detected and characterized from cardiac magnetic resonance without gadolinium-based contrast agents using native-T1 maps at 3T. We aimed to investigate the diagnostic capacity of this approach for characterizing chronic myocardial infarctions (MIs) in a multi-center setting. Methods: Patients with a prior MI (n=105) were recruited at 3 different medical centers and were imaged with native-T1 mapping and late gadolinium enhancement (LGE) at 3T. Infarct location, size, and transmurality were determined from native-T1 maps and LGE. Sensitivity, specificity, receiver-operating characteristic metrics, and inter- and intraobserver variabilities were assessed relative to LGE. Results: Across all subjects, T1 of MI territory was 1621±110 ms, and remote territory was 1225±75 ms. Sensitivity, specificity, and area under curve for detecting MI location based on native-T1 mapping relative to LGE were 88%, 92%, and 0.93, respectively. Native-T1 maps were not different for measuring infarct size (native-T1 maps: 12.1±7.5%; LGE: 11.8±7.2%, P=0.82) and were in agreement with LGE (R2=0.92, bias, 0.09±2.6%). Corresponding inter- and intraobserver assessments were also highly correlated (interobserver: R2=0.90, bias, 0.18±2.4%; and intraobserver: R2=0.91, bias, 0.28±2.1%). Native T1 maps were not different for measuring MI transmurality (native-T1 maps: 49.1±15.8%; LGE: 47.2±19.0%, P=0.56) and showed agreement (R2=0.71; bias, 1.32±10.2%). Corresponding inter- and intraobserver assessments were also in agreement (interobserver: R2=0.81, bias, 0.1±9.4%; and intraobserver: R2=0.91, bias, 0.28±2.1%, respectively). While the overall accuracy for detecting MI with native-T1 maps at 3T was high, logistic regression analysis showed that MI location was a prominent confounder. Conclusions: Native-T1 mapping can be used to image chronic MI with high degree of accuracy, and as such, it is a viable alternative for scar imaging in patients with chronic MI who are contraindicated for LGE. Technical advancements may be needed to overcome the imaging confounders that currently limit native-T1 mapping from reaching equivalent detection levels as LGE.
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影响因子：
6.4
作者：
Janardhanan R;Jiji RS;Brooks J;Epstein FH;Kramer CM;Salerno M
通讯作者：
Salerno M
影响因子：
168.9
作者：
Makkar, Raj R.;Smith, Rachel R.;Cheng, Ke;Malliaras, Konstantinos;Thomson, Louise E. J.;Berman, Daniel;Czer, Lawrence S. C.;Marban, Linda;Mendizabal, Adam;Johnston, Peter V.;Russell, Stuart D.;Schuleri, Karl H.;Lardo, Albert C.;Gerstenblith, Gary;Marban, Eduardo
通讯作者：
Marban, Eduardo
DOI：
10.1161/circimaging.113.001541
发表时间：
2014-05
期刊：
Circulation. Cardiovascular imaging
影响因子：
--
作者：
Kali A;Cokic I;Tang RL;Yang HJ;Sharif B;Marbán E;Li D;Berman DS;Dharmakumar R
通讯作者：
Dharmakumar R
影响因子：
24
作者：
Amado, LC;Gerber, BL;Lima, JAC
通讯作者：
Lima, JAC
DOI：
10.1007/bf02957087
发表时间：
1966
期刊：
Irish Journal of Medical Science (1926-1967)
影响因子：
--
作者：
D. Abou
通讯作者：
D. Abou