Quantification of both the area-at-risk and acute myocardial infarct size in ST-segment elevation myocardial infarction using T1-mapping

Journal of Cardiovascular Magnetic Resonance

Research

Anna S. Herrey¹  Charlotte Manisty¹  Marianna Fontana²  Daniel S. Knight²  Peter Kellman³  Matthew Hammond-Haley⁴  Heerajnarain Bulluck⁴  Derek J. Hausenloy⁵  Alex Sirker⁶  James C. Moon⁶ 

[1] Barts Heart Centre, St Bartholomew’s Hospital, London, UK;National Amyloidosis Centre, University College London, Royal Free Hospital, London, UK;National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, USA;The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, London, UK;The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, London, UK;The National Institute of Health Research University College London Hospitals Biomedical Research Centre, London, UK;Barts Heart Centre, St Bartholomew’s Hospital, London, UK;Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore, Singapore, Singapore;National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore;Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore;The National Institute of Health Research University College London Hospitals Biomedical Research Centre, London, UK;Barts Heart Centre, St Bartholomew’s Hospital, London, UK;

关键词: ST-segment elevation myocardial infarction;    Primary percutaneous coronary intervention;    Myocardial infarct size;    Area-at-risk;    T1-mapping;    T2-mapping;    Cardiovascular magnetic resonance;   

DOI  :  10.1186/s12968-017-0370-6

 received in 2017-03-20, accepted in 2017-07-04,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundA comprehensive cardiovascular magnetic resonance (CMR) in reperfused ST-segment myocardial infarction (STEMI) patients can be challenging to perform and can be time-consuming. We aimed to investigate whether native T1-mapping can accurately delineate the edema-based area-at-risk (AAR) and post-contrast T1-mapping and synthetic late gadolinium (LGE) images can quantify MI size at 1.5 T. Conventional LGE imaging and T2-mapping could then be omitted, thereby shortening the scan duration.MethodsTwenty-eight STEMI patients underwent a CMR scan at 1.5 T, 3 ± 1 days following primary percutaneous coronary intervention. The AAR was quantified using both native T1 and T2-mapping. MI size was quantified using conventional LGE, post-contrast T1-mapping and synthetic magnitude-reconstructed inversion recovery (MagIR) LGE and synthetic phase-sensitive inversion recovery (PSIR) LGE, derived from the post-contrast T1 maps.ResultsNative T1-mapping performed as well as T2-mapping in delineating the AAR (41.6 ± 11.9% of the left ventricle [% LV] versus 41.7 ± 12.2% LV, P = 0.72; R2 0.97; ICC 0.986 (0.969–0.993); bias −0.1 ± 4.2% LV). There were excellent correlation and inter-method agreement with no bias, between MI size by conventional LGE, synthetic MagIR LGE (bias 0.2 ± 2.2%LV, P = 0.35), synthetic PSIR LGE (bias 0.4 ± 2.2% LV, P = 0.060) and post-contrast T1-mapping (bias 0.3 ± 1.8% LV, P = 0.10). The mean scan duration was 58 ± 4 min. Not performing T2 mapping (6 ± 1 min) and conventional LGE (10 ± 1 min) would shorten the CMR study by 15–20 min.ConclusionsT1-mapping can accurately quantify both the edema-based AAR (using native T1 maps) and acute MI size (using post-contrast T1 maps) in STEMI patients without major cardiovascular risk factors. This approach would shorten the duration of a comprehensive CMR study without significantly compromising on data acquisition and would obviate the need to perform T2 maps and LGE imaging.

【 授权许可】

CC BY   
© The Author(s). 2017