In vivo contrast free chronic myocardial infarction characterization using diffusion-weighted cardiovascular magnetic resonance

Journal of Cardiovascular Magnetic Resonance

Research

Zhaoyang Fan¹  Behzad Sharif¹  Yibin Xie²  Christopher Nguyen²  Debiao Li²  Rohan Dharmakumar³  Eleni Tseliou⁴  Eduardo Marbán⁴  James Dawkins⁴  Xiaoming Bi⁵ 

[1] Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 116 N. Robertson Blvd Suite 800, 90048, Los Angeles, CA, USA;Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 116 N. Robertson Blvd Suite 800, 90048, Los Angeles, CA, USA;Department of Bioengineering, University of California Los Angeles, 420 Westwood Plaza, Engineering V Room 5121, 90095, Los Angeles, CA, USA;Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 116 N. Robertson Blvd Suite 800, 90048, Los Angeles, CA, USA;Department of Bioengineering, University of California Los Angeles, 420 Westwood Plaza, Engineering V Room 5121, 90095, Los Angeles, CA, USA;Heart Institute, Cedars-Sinai Medical Center, A3600, 127 S. San Vincente Blvd. Advanced Health Sciences Pavilion, 90048, Los Angeles, CA, USA;Heart Institute, Cedars-Sinai Medical Center, A3600, 127 S. San Vincente Blvd. Advanced Health Sciences Pavilion, 90048, Los Angeles, CA, USA;MR Research and Development, Siemens Healthcare, 116 N. Robertson Blvd Suite 800, 90048, Los Angeles, CA, USA;

关键词: Apparent Diffusion Coefficient;    Cardiovascular Magnetic Resonance;    Late Gadolinium Enhance;    Infarct Volume;    Regional Wall Motion;   

DOI  :  10.1186/s12968-014-0068-y

 received in 2014-04-07, accepted in 2014-08-13,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundDespite the established role of late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) in characterizing chronic myocardial infarction (MI), a significant portion of chronic MI patients are contraindicative for the use of contrast agents. One promising alternative contrast free technique is diffusion weighted CMR (dwCMR), which has been shown ex vivo to be sensitive to myocardial fibrosis. We used a recently developed in vivo dwCMR in chronic MI pigs to compare apparent diffusion coefficient (ADC) maps with LGE imaging for infarct characterization.MethodsIn eleven mini pigs, chronic MI was induced by complete occlusion of the left anterior descending artery for 150 minutes. LGE, cine, and dwCMR imaging was performed 8 weeks post MI. ADC maps were derived from three orthogonal diffusion directions (b = 400 s/mm2) and one non-diffusion weighted image. Two semi-automatic infarct classification methods, threshold and full width half max (FWHM), were performed in both LGE and ADC maps. Regional wall motion (RWM) analysis was performed and compared to ADC maps to determine if any observed ADC change was significantly influenced by bulk motion.ResultsADC of chronic MI territories was significantly increased (threshold: 2.4 ± 0.3 μm2/ms, FWHM: 2.4 ± 0.2 μm2/ms) compared to remote myocardium (1.4 ± 0.3 μm2/ms). RWM was significantly reduced (threshold: 1.0 ± 0.4 mm, FWHM: 0.9 ± 0.4 mm) in infarcted regions delineated by ADC compared to remote myocardium (8.3 ± 0.1 mm). ADC-derived infarct volume and location had excellent agreement with LGE. Both LGE and ADC were in complete agreement when identifying transmural infarcts. Additionally, ADC was able to detect LGE-delineated infarcted segments with high sensitivity, specificity, PPV, and NPV. (threshold: 0.88, 0.93, 0.87, and 0.94, FWHM: 0.98, 0.97, 0.93, and 0.99, respectively).ConclusionsIn vivo diffusion weighted CMR has potential as a contrast free alternative for LGE in characterizing chronic MI.

【 授权许可】

Unknown   
© Nguyen et al.; licensee BioMed Central Ltd. 2014. 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/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.