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


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2014-09-17

AUTHORS

Christopher Nguyen, Zhaoyang Fan, Yibin Xie, James Dawkins, Eleni Tseliou, Xiaoming Bi, Behzad Sharif, Rohan Dharmakumar, Eduardo Marbán, Debiao Li

ABSTRACT

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. More... »

PAGES

68

References to SciGraph publications

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URI

http://scigraph.springernature.com/pub.10.1186/s12968-014-0068-y

DOI

http://dx.doi.org/10.1186/s12968-014-0068-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1009456208

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25230598


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26 schema:description 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.
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32 schema:keywords ADC
33 ADC changes
34 ADC maps
35 BackgroundDespite
36 ConclusionsIn
37 LGE
38 MI patients
39 MI pigs
40 MI territory
41 NPV
42 PPV
43 RWM
44 ResultsADC
45 agents
46 agreement
47 alternative
48 analysis
49 anterior
50 apparent diffusion coefficient (ADC) maps
51 artery
52 bulk motion
53 cardiovascular magnetic resonance
54 changes
55 characterization
56 chronic MI patients
57 chronic myocardial infarction
58 cine
59 classification method
60 coefficient maps
61 complete agreement
62 complete occlusion
63 contrast agents
64 diffusion
65 diffusion coefficient maps
66 diffusion direction
67 direction
68 enhancement cardiovascular magnetic resonance
69 excellent agreement
70 fibrosis
71 free alternative
72 free technique
73 full width half max
74 half max
75 high sensitivity
76 images
77 imaging
78 infarct characterization
79 infarct volume
80 infarcted region
81 infarcted segments
82 infarction
83 infarcts
84 late gadolinium enhancement cardiovascular magnetic resonance
85 left anterior
86 location
87 magnetic resonance
88 maps
89 max
90 method
91 mini pigs
92 minutes
93 motion
94 motion analysis
95 myocardial fibrosis
96 myocardial infarction
97 myocardium
98 occlusion
99 patients
100 pigs
101 portion
102 region
103 regional wall motion analysis
104 remote myocardium
105 resonance
106 role
107 segments
108 sensitivity
109 significant portion
110 specificity
111 technique
112 territory
113 threshold
114 transmural infarcts
115 use
116 vivo
117 volume
118 wall motion analysis
119 weeks
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