A non-contrast CMR index for assessing myocardial fibrosis.
A non-contrast CMR index for assessing myocardial fibrosis.
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用于评估心肌纤维化的非对比度CMR指数。
DOI：
10.1016/j.mri.2017.04.012
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发表时间：
2017-10
影响因子：
2.5
通讯作者：
Zheng J
中科院分区：
文献类型：
--
作者：
Yin Q;Abendschein D;Muccigrosso D;O'Connor R;Goldstein T;Chen R;Zheng J
需要安全、敏感和无创的影像学方法来评估心肌纤维化的存在、程度和转归，以便对心肌梗死后可能发生心力衰竭的患者进行早期风险分层。我们描述了一种非对比心脏磁共振（CMR）的方法敏感检测心肌纤维化的犬模型心肌梗死和再灌注。7只犬左前降支冠状动脉血栓闭塞，随后进行纤溶再灌注。CMR研究在再灌注后7天进行。采用CMR自旋锁定T1ρ映射序列获得自旋锁定频率为0和511 Hz的T1ρ色散数据。纤维化指数图是在逐像素的基础上得出的。CMR自然T1标测、首过心肌灌注成像和造影后晚期钆增强成像也用于评估心肌缺血和纤维化。CMR后解剖心脏进行组织病理学染色，并对相邻左心室切片间隔区的两个心肌组织段进行定性评估，以分级心肌纤维化的程度。间隔区14个心肌组织节段的组织学分级为1级（纤维化面积，低倍视野的20%，n = 9）、2级（纤维化面积，视野的20-50%，n = 4）或3级（纤维化面积，视野的>50%，n = 1）。CMR从1级到2级观察到纤维化指数的显著差异（183%，P < 0.001），而T1ρ（9%，P = 0.14），天然T1（5.5%，P = 0.12）和灌注（-21%，P = 0.05）的差异要小得多。在初步研究中，基于T1ρ离散度对比度的非对比CMR指数显示可检测组织病理学鉴定的心肌纤维化程度并与之相关。非造影剂方法可能对管理心力衰竭心脏病患者具有重要意义，特别是在存在肾功能受损的情况下。
Safe, sensitive, and non-invasive imaging methods to assess the presence, extent, and turnover of myocardial fibrosis are needed for early stratification of risk in patients who might develop heart failure after myocardial infarction. We describe a non-contrast cardiac magnetic resonance (CMR) approach for sensitive detection of myocardial fibrosis using a canine model of myocardial infarction and reperfusion. Seven dogs had coronary thrombotic occlusion of the left anterior descending coronary arteries followed by fibrinolytic reperfusion. CMR studies were performed at 7 days after reperfusion. A CMR spin-locking T1ρ mapping sequence was used to acquire T1ρ dispersion data with spin-lock frequencies of 0 and 511 Hz. A fibrosis index map was derived on a pixel-by-pixel basis. CMR native T1 mapping, first-pass myocardial perfusion imaging, and post-contrast late gadolinium enhancement imaging were also performed for assessing myocardial ischemia and fibrosis. Hearts were dissected after CMR for histopathological staining and two myocardial tissue segments from the septal regions of adjacent left ventricular slices were qualitatively assessed to grade the extent of myocardial fibrosis. Histopathology of 14 myocardial tissue segments from septal regions was graded as grade 1 (fibrosis area, <20% of a low power field, n = 9), grade 2 (fibrosis area, 20–50% of field, n = 4), or grade 3 (fibrosis area, >50% of field, n = 1). A dramatic difference in fibrosis index (183%, P < 0.001) was observed by CMR from grade 1 to 2, whereas differences were much smaller for T1ρ (9%, P = 0.14), native T1 (5.5%, P = 0.12), and perfusion (−21%, P = 0.05). A non-contrast CMR index based on T1ρ dispersion contrast was shown in preliminary studies to detect and correlate with the extent of myocardial fibrosis identified histopathologically. A non-contrast approach may have important implications for managing cardiac patients with heart failure, particularly in the presence of impaired renal function.
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DOI：
10.1161/circimaging.108.842096
发表时间：
2010-11
期刊：
Circulation. Cardiovascular imaging
影响因子：
--
作者：
Broberg CS;Chugh SS;Conklin C;Sahn DJ;Jerosch-Herold M
通讯作者：
Jerosch-Herold M
影响因子：
3.6
作者：
Talman, Virpi;Ruskoaho, Heikki
通讯作者：
Ruskoaho, Heikki
影响因子：
6.2
作者：
Kosmala, Wojciech;Przewlocka-Kosmala, Monika;Marwick, Thomas H.
通讯作者：
Marwick, Thomas H.
影响因子：
17.1
作者：
Moeckel D;Jeong SS;Sun X;Broekman MJ;Nguyen A;Drosopoulos JH;Marcus AJ;Robson SC;Chen R;Abendschein D
通讯作者：
Abendschein D
影响因子：
7.5
作者：
Miller, Christopher A.;Naish, Josephine H.;Schmitt, Matthias
通讯作者：
Schmitt, Matthias