The impact of hematocrit on oxygenation-sensitive cardiovascular magnetic resonance

Journal of Cardiovascular Magnetic Resonance

Research

Gobinath Nadeshalingam¹  Kady Fischer²  Dominik P. Guensch³  Matthias G. Friedrich⁴  Aurelien F. Stalder⁵ 

[1] Philippa & Marvin Carsley CMR Centre at the Montreal Heart Institute, Montreal, QC, Canada;Philippa & Marvin Carsley CMR Centre at the Montreal Heart Institute, Montreal, QC, Canada;Department of Anesthesiology and Pain Therapy, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland;Philippa & Marvin Carsley CMR Centre at the Montreal Heart Institute, Montreal, QC, Canada;Department of Anesthesiology and Pain Therapy, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland;Instutite of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland;Philippa & Marvin Carsley CMR Centre at the Montreal Heart Institute, Montreal, QC, Canada;Department of Medicine, Heidelberg University, Heidelberg, Germany;Departments of Cardiac Sciences and Radiology, University of Calgary, Calgary, AB, Canada;Department of Radiology, Université de Montréal, Montreal, QC, Canada;Departments of Medicine and Radiology, McGill University Health Centre, Montreal, QC, Canada;Siemens Healthcare GmbH, Erlangen, Germany;

关键词: Hematocrit;    Hemoglobin;    Hemodilution;    BOLD-CMR;    OS-CMR;    T2*;   

DOI  :  10.1186/s12968-016-0262-1

 received in 2016-03-02, accepted in 2016-06-28,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundOxygenation-sensitive (OS) Cardiovascular Magnetic Resonance (CMR) is a promising utility in the diagnosis of heart disease. Contrast in OS-CMR images is generated through deoxyhemoglobin in the tissue, which is negatively correlated with the signal intensity (SI). Thus, changing hematocrit levels may be a confounder in the interpretation of OS-CMR results. We hypothesized that hemodilution confounds the observed signal intensity in OS-CMR images.MethodsVenous and arterial blood from five pigs was diluted with lactated Ringer solution in 10 % increments to 50 %. The changes in signal intensity (SI) were compared to changes in blood gases and hemoglobin concentration. We performed an OS-CMR scan in 21 healthy volunteers using vasoactive breathing stimuli at baseline, which was then repeated after rapid infusion of 1 L of lactated Ringer’s solution within 5–8 min. Changes of SI were measured and compared between the hydration states.ResultsThe % change in SI from baseline for arterial (r = -0.67, p < 0.0001) and venous blood (r = -0.55, p = 0.002) were negatively correlated with the changes in hemoglobin (Hb). SI changes in venous blood were also associated with SO2 (r = 0.68, p < 0.0001) and deoxyHb concentration (-0.65, p < 0.0001). In healthy volunteers, rapid infusion resulted in a significant drop in the hemoglobin concentration (142.5 ± 15.2 g/L vs. 128.8 ± 15.2 g/L; p < 0.0001). Baseline myocardial SI increased by 3.0 ± 5.7 % (p = 0.026) following rapid infusion, and in males there was a strong association between the change in hemoglobin concentration and % changes in SI (r = 0.82, p = 0.002). After hyperhydration, the SI response after hyperventilation was attenuated (HV, p = 0.037), as was the maximum SI increase during apnea (p = 0.012). The extent of SI attenuation was correlated with the reduction in hemoglobin concentration at the end of apnea (r = 0.55, p = 0.012) for all subjects and at maximal SI (r = 0.63, p = 0.037) and the end of breath-hold (r = 0.68, p = 0.016) for males only.ConclusionIn dynamic studies using oxygenation-sensitive CMR, the hematocrit level affects baseline signal intensity and the observed signal intensity response. Thus, the hydration status of the patient may be a confounder for OS-CMR image analysis.

【 授权许可】

CC BY   
© The Author(s). 2016