Rapid ungated myocardial perfusion cardiovascular magnetic resonance: preliminary diagnostic accuracy

Journal of Cardiovascular Magnetic Resonance

Research

Kavitha Damal¹  Ganesh Adluru²  Edward V R DiBella³  Daniel Kim⁴  Akram M Shaaban⁵  Alexis Harrison⁶  Brent Wilson⁶  Chris McGann⁶  Nassir F Marrouche⁶ 

[1] CARMA, Department of Internal Medicine, Salt Lake City, UT, USA;CARMA, Department of Internal Medicine, Salt Lake City, UT, USA;Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, UT, USA;CARMA, Department of Internal Medicine, Salt Lake City, UT, USA;Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, UT, USA;Department of Bioengineering, University of Utah, Salt Lake City, UT, USA;Department of Radiology, University of Utah, Salt Lake City, UT, USA;CARMA, Department of Internal Medicine, Salt Lake City, UT, USA;Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, UT, USA;Department of Radiology, University of Utah, Salt Lake City, UT, USA;Department of Radiology, University of Utah, Salt Lake City, UT, USA;Division of Cardiology, University of Utah, Salt Lake City, UT, USA;CARMA, Department of Internal Medicine, Salt Lake City, UT, USA;

关键词: Gating;    ECG;    Ungated cardiac MR;    Myocardial perfusion imaging;    Cardiac perfusion;    Contrast-enhanced MRI;   

DOI  :  10.1186/1532-429X-15-26

 received in 2012-10-21, accepted in 2013-03-08,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundMyocardial perfusion cardiovascular magnetic resonance (CMR) is a well-established method for detection of ischemic heart disease. However, ECG gating problems can result in image degradation and non-diagnostic scans, particularly in patients with arrhythmias.MethodsA turboFLASH saturation recovery pulse sequence was used without any ECG triggering. One saturation pulse followed by 4–5 slices of undersampled radial k-space images was acquired rapidly, on the order of 40–50 msec per image. The acquisition of the set of 4–5 slices was continuously repeated approximately 4 times per second. An iterative constrained reconstruction method was used to reconstruct the ungated images. The ungated perfusion images were post-processed into three different sets of images (ungated, self-gated to near systole, and self-gated to near diastole). To test the ungated approach and compare the different processing methods, 8 patients scheduled for coronary angiography underwent stress and rest perfusion imaging with the ungated acquisition. Six patients had a history of atrial fibrillation (AF). Three blinded readers assessed image quality and presence/absence of disease.ResultsAll 8 subjects successfully completed the perfusion CMR protocol and 7/8 underwent coronary angiography. Three patients were in atrial fibrillation during CMR. Overall, the CMR images were of high quality as assessed by the three readers. There was little difference in image quality between patients in AF compared to those in sinus rhythm (3.6±0.7 vs. 3.3±0.5). Stress/rest perfusion imaging showed normal perfusion in 4 patients, fixed perfusion defects in 2 patients, and reversible perfusion defects in 2 patients, corresponding with angiographic results. Pooled results from the independent readers gave a sensitivity of 0.92 (CI 0.65-0.99) and specificity of 0.92 (CI 0.65-0.99) for the detection of coronary artery disease using ungated perfusion imaging. The same sensitivity, and a specificity of 1 (CI 0.76-1), was achieved when the images were self-gated after acquisition into near systole or near diastole.ConclusionsUngated radial dynamic perfusion CMR can give high quality imaging in patients in sinus rhythm and during atrial fibrillation. In this small cohort, high diagnostic accuracy was possible with this rapid perfusion imaging sequence. An ungated approach simplifies the acquisition and could expand the role of perfusion CMR to include patients with arrhythmia and those with gating problems.

【 授权许可】

Unknown   
© Harrison et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.