Detection of Acute Reperfusion Myocardial Hemorrhage with Cardiac MR Imaging: T2 versus T2*
Detection of Acute Reperfusion Myocardial Hemorrhage with Cardiac MR Imaging: T2 versus T2*
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DOI：
10.1148/radiol.13122397
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发表时间：
2013-11-01
期刊：
影响因子：
19.7
通讯作者：
Dharmakumar, Rohan
中科院分区：
文献类型：
--
作者：
Kali, Avinash;Tang, Richard L. Q.;Dharmakumar, Rohan
目的：评估T2和T2* 的变化，急性再灌注出血性和非出血性心肌梗死，并确定哪种技术更适合于在1.5 T的心肌内出血的检测。材料和方法：患者研究机构审查委员会批准，并符合HIPAA。首次ST段抬高心肌梗死患者（n = 14，3名女性）在血管成形术后3天进行心脏磁共振（MR）成像。采集T2* 图、T2短反转时间反转恢复（STIR）图像和晚期钆增强（LGE）图像。动物研究由机构动物护理和使用委员会批准。犬（n = 20）遭受缺血再灌注损伤，再灌注5天后进行心脏MR成像。获取T2* 和T2图以及T2 STIR和LGE图像。采用重复测量方差分析或Friedman检验比较出血性梗死和非出血性梗死患者的T2和T2* 变化。相对于远端心肌，出血性梗死的平均T2* 为54% +/- 13（标准差）在患者中较低（15.9 msec +/- 4.5 vs 35.2 msec +/- 2.1，P < .001），在犬中较低40% +/- 10（23.0 msec +/- 4.0 vs 39.3 msec +/- 2.5，P < .001）。患者非出血性梗死的平均T2* 略微升高6% +/- 2.5（37.8 msec +/- 2.5，P = 0.021），犬升高8% +/- 5（44.6 msec +/- 4.8，P = 0.012）。与此相反，出血性梗死和非出血性梗死的平均T2 STIR信号强度（SI）均高于远处心肌（出血性：37% +/- 19，P <0.001;非出血性：78% +/- 27，P <0.001）（出血性：42% +/- 22，P < .001;非出血性：65% +/- 22，P < .001）。与STIR SI结果一致，两种出血性的平均T2（62.0 msec +/- 4.9）和非出血性（71.7 msec +/- 7.3）犬的梗死相对于远端心肌的平均T2升高（52.1 msec +/- 4.8）分别增加18% +/- 9和38% +/- 13（P <0.001）。结论：T2心脏MR成像比T2心脏MR成像更适合于急性再灌注心肌出血的检测和定性。(C)RSNA，2013年
Purpose: To evaluate T2 and T2* changes in acute reperfused hemorrhagic and nonhemorrhagic myocardial infarctions and to determine which technique is more suitable in the detection of intramyocardial hemorrhage at 1.5 T.Materials and Methods: Patient studies were approved by the institutional review board and were HIPAA compliant. Patients (n = 14, three women) with first ST-elevation myocardial infarction underwent cardiac magnetic resonance (MR) imaging 3 days after angioplasty. T2* maps, T2 short inversion time inversion-recovery (STIR) images, and late gadolinium enhancement (LGE) images were acquired. Animal studies were approved by the institutional animal care and use committee. Canines (n = 20) were subjected to ischemia-reperfusion injury, and cardiac MR imaging was performed 5 days after reperfusion. T2* and T2 maps and T2 STIR and LGE images were acquired. Repeated-measures analysis of variance or the Friedman test was used to compare T2 and T2* changes in patients with hemorrhagic infarctions and those with nonhemorrhagic infarctions.Results: Relative to remote myocardium, mean T2* of hemorrhagic infarctions was 54% +/- 13 (standard deviation) lower in patients (15.9 msec +/- 4.5 vs 35.2 msec +/- 2.1, P < .001) and 40% +/- 10 lower in canines (23.0 msec +/- 4.0 vs 39.3 msec +/- 2.5, P < .001). Mean T2* of nonhemorrhagic infarctions was marginally elevated by 6% +/- 2.5 (37.8 msec +/- 2.5, P = .021) in patients and by 8% +/- 5 (44.6 msec +/- 4.8, P = .012) in canines. In contrast, mean T2 STIR signal intensity (SI) of both hemorrhagic infarctions and nonhemorrhagic infarctions was higher than that in remote myocardium both in patients (hemorrhagic: 37% +/- 19, P < .001; nonhemorrhagic: 78% +/- 27, P < .001) and in canines (hemorrhagic: 42% +/- 22, P < .001; nonhemorrhagic: 65% +/- 22, P < .001). Consistent with STIR SI findings, mean T2 of both hemorrhagic (62.0 msec +/- 4.9) and nonhemorrhagic (71.7 msec +/- 7.3) infarctions in canines was elevated relative to mean T2 of remote myocardium (52.1 msec +/- 4.8) by 18% +/- 9 and 38% +/- 13, respectively (P < .001 for both).Conclusion: T2* cardiac MR imaging is more suitable than T2 cardiac MR imaging in the detection and characterization of acute reperfusion myocardial hemorrhage. (C) RSNA, 2013