Cardiovascular magnetic resonance imaging of myocardial oedema following acute myocardial infarction: Is whole heart coverage necessary?

Journal of Cardiovascular Magnetic Resonance

Research

Saidi Mohiddin¹  James C. Moon¹  Tom Burchell¹  Cyril Pellaton¹  Danielle Longchamp¹  Stephen Hamshere¹  Mark Westwood¹  Didier Locca²  Anthony Mathur³  Steffen E. Petersen³  Daniel A. Jones³  Jens Kastrup⁴ 

[1] Department of Cardiology, Barts Heart Centre, St Bartholomews Hospital, Barts Health NHS Trust, EC1A 7BE, London, UK;Department of Cardiology, Barts Heart Centre, St Bartholomews Hospital, Barts Health NHS Trust, EC1A 7BE, London, UK;Service de Cardiologie et Département de Médecine Interne, Centre Hospitalier Universitaire, Vaudois, Lausanne, Switzerland;Department of Cardiology, Barts Heart Centre, St Bartholomews Hospital, Barts Health NHS Trust, EC1A 7BE, London, UK;William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary University of London, Charterhouse Square, EC1M 6BQ, London, UK;Department of Cardiology, Rigshopitale, University of Copenhagen, Copenhagen, Denmark;

关键词: Cardiac Magnetic Resonance;    Acute Myocardial Infarction;    Late Gadolinium Enhancement;    Cardiac Magnetic Resonance Imaging;    Primary Percutaneous Coronary Intervention;   

DOI  :  10.1186/s12968-016-0226-5

 received in 2015-08-19, accepted in 2016-01-12,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAAR measurement is useful when assessing the efficacy of reperfusion therapy and novel cardioprotective agents after myocardial infarction. Multi-slice (Typically 10-12) T2-STIR has been used widely for its measurement, typically with a short axis stack (SAX) covering the entire left ventricle, which can result in long acquisition times and multiple breath holds. This study sought to compare 3-slice T2-short-tau inversion recovery (T2- STIR) technique against conventional multi-slice T2-STIR technique for the assessment of area at risk (AAR).MethodsCMR imaging was performed on 167 patients after successful primary percutaneous coronary intervention. 82 patients underwent a novel 3-slice SAX protocol and 85 patients underwent standard 10-slice SAX protocol. AAR was obtained by manual endocardial and epicardial contour mapping followed by a semi- automated selection of normal myocardium; the volume was expressed as mass (%) by two independent observers.Results85 patients underwent both 10-slice and 3-slice imaging assessment showing a significant and strong correlation (intraclass correlation coefficient = 0.92;p < 0.0001) and a low Bland-Altman limit (mean difference −0.03 ± 3.21 %, 95 % limit of agreement,- 6.3 to 6.3) between the 2 analysis techniques. A further 82 patients underwent 3-slice imaging alone, both the 3-slice and the 10-slice techniques showed statistically significant correlations with angiographic risk scores (3-slice to BARI r = 0.36, 3-slice to APPROACH r = 0.42, 10-slice to BARI r = 0.27, 10-slice to APPROACH r = 0.46). There was low inter-observer variability demonstrated in the 3-slice technique, which was comparable to the 10-slice method (z = 1.035, p = 0.15). Acquisition and analysis times were quicker in the 3-slice compared to the 10-slice method (3-slice median time: 100 seconds (IQR: 65-171 s) vs (10-slice time: 355 seconds (IQR: 275-603 s); p < 0.0001.ConclusionsAAR measured using 3-slice T2-STIR technique correlates well with standard 10-slice techniques, with no significant bias demonstrated in assessing the AAR. The 3-slice technique requires less time to perform and analyse and is therefore advantageous for both patients and clinicians.

【 授权许可】

CC BY   
© Hamshere et al. 2016