Three-dimensional maximum principal strain using cardiac computed tomography for identification of myocardial infarction
Three-dimensional maximum principal strain using cardiac computed tomography for identification of myocardial infarction
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DOI：
10.1007/s00330-016-4550-9
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发表时间：
2017-04-01
影响因子：
5.9
通讯作者：
Mochizuki, Teruhito
中科院分区：
文献类型：
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作者：
Tanabe, Yuki;Kido, Teruhito;Mochizuki, Teruhito
为评价心脏CT三维最大主应变(MP应变)检测心肌梗死(MI)的可行性，对43例接受心脏CT和磁共振成像(MRI)的患者进行了回顾性研究。利用运动相干算法中的体素跟踪算法，利用16节段模型测量峰值CT MP应变。根据晚期Gd强化的跨壁范围(LGE)和与MI的距离，将所有节段分为梗死组、边缘节段、邻近节段和远隔节段，将梗死节段和边缘节段定义为LGE阳性的MI。通过节段水平的受试者操作特征曲线分析，比较MP应变对MI的诊断性能与MRI评估的收缩期壁增厚百分比(%SWT)。在排除16个受伪影影响的672个节段中，193个节段被诊断为MI。与%SWT分别为76%(60~95%)和68%(48~84%)相比，MP峰值菌株诊断MI的敏感性和特异性分别为81%[95%可信区间(95%CI)：74~88%]和86%(81~92%)。峰值MP应变曲线下面积优于%SWT[0.90(0.87~0.93)vs.0.80(0.76~0.83)，p<；0.05]。CT MP应变对冠状动脉CTA检测心肌梗死具有增量价值。CT MP应变可三维评价局部心功能。CT MP应变对心肌梗死具有较高的诊断准确性。CT MP应变有助于LGE-MRI评价心肌的组织学特征。CT MP应变为冠状动脉CTA检测心肌梗死提供增量价值。
To evaluate the feasibility of three-dimensional (3D) maximum principal strain (MP-strain) derived from cardiac computed tomography (CT) for detecting myocardial infarction (MI).Forty-three patients who underwent cardiac CT and magnetic resonance imaging (MRI) were retrospectively selected. Using the voxel tracking of motion coherence algorithm, the peak CT MP-strain was measured using the 16-segment model. With the trans-mural extent of late gadolinium enhancement (LGE) and the distance from MI, all segments were classified into four groups (infarcted, border, adjacent, and remote segments); infarcted and border segments were defined as MI with LGE positive. Diagnostic performance of MP-strain for detecting MI was compared with per cent systolic wall thickening (%SWT) assessed by MRI using receiver-operating characteristic curve analysis at a segment level.Of 672 segments excluding16 segments influenced by artefacts, 193 were diagnosed as MI. Sensitivity and specificity of peak MP-strain to identify MI were 81 % [95 % confidence interval (95 % CI): 74-88 %] and 86 % (81-92 %) compared with %SWT: 76 % (60-95 %) and 68 % (48-84 %), respectively. The area under the curve of peak MP-strain was superior to %SWT [0.90 (0.87-0.93) vs. 0.80 (0.76-0.83), p < 0.05].CT MP-strain has a potential to provide incremental value to coronary CT angiography for detecting MI.CT MP-strain allows for three-dimensional assessment of regional cardiac function.CT-MP strain has high diagnostic accuracy for detecting myocardial infarction.CT-MP strain may assist in tissue characterisation of myocardium assessed by LGE-MRI.CT-MP strain provides incremental values to coronary CTA for detecting myocardial infarction.