Retrospective assessment of at-risk myocardium in reperfused acute myocardial infarction patients using contrast‐enhanced balanced steady‐state free‐precession cardiovascular magnetic resonance at ... View Full Text


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Article Info

DATE

2021-03-15

AUTHORS

Zheng Sun, Qiuhang Zhang, Huan Zhao, Chengxi Yan, Hsin-Jung Yang, Debiao Li, Kuncheng Li, Zhi Liu, Qi Yang, Rohan Dharmakumar

ABSTRACT

BackgroundContrast-enhanced (CE) steady-state free precession (SSFP) CMR at 1.5T has been shown to be a valuable alternative to T2-based methods for the detection and quantifications of area-at-risk (AAR) in acute myocardial infarction (AMI) patients. However, CE-SSFP’s capacity for assessment of AAR at 3T has not been investigated. We examined the clinical utility of CE-SSFP and T2-STIR for the retrospective assessment of AAR at 3T with single-photon-emission-computed tomography (SPECT) validation.Materials and methodsA total of 60 AMI patients (ST-elevation AMI, n = 44; non-ST-elevation AMI, n = 16) were recruited into the CMR study between 3 and 7 days post revascularization. All patients underwent T2-STIR, CE-bSSFP and late-gadolinium-enhancement CMR. For validation, SPECT images were acquired in a subgroup of patients (n = 30).ResultsIn 53 of 60 patients (88 %), T2-STIR was of diagnostic quality compared with 54 of 60 (90 %) with CE-SSFP. In a head-to-head per-slice comparison (n = 365), there was no difference in AAR quantified using T2-STIR and CE-SSFP (R2 = 0.92, p < 0.001; bias:-0.4 ± 0.8 cm2, p = 0.46). On a per-patient basis, there was good agreement between CE-SSFP (n = 29) and SPECT (R2 = 0.86, p < 0.001; bias: − 1.3 ± 7.8 %LV, p = 0.39) for AAR determination. T2-STIR also showed good agreement with SPECT for AAR measurement (R2 = 0.81, p < 0.001, bias: 0.5 ± 11.1 %LV, p = 0.81). There was also a strong agreement between CE-SSFP and T2-STIR with respect to the assessment of AAR on per-patient analysis (R2 = 0.84, p < 0.001, bias: − 2.1 ± 10.1 %LV, p = 0.31).ConclusionsAt 3T, both CE-SSFP and T2-STIR can retrospectively quantify the at-risk myocardium with high accuracy. More... »

PAGES

25

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12968-021-00730-7

DOI

http://dx.doi.org/10.1186/s12968-021-00730-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1136398126

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33715636


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32 schema:description BackgroundContrast-enhanced (CE) steady-state free precession (SSFP) CMR at 1.5T has been shown to be a valuable alternative to T2-based methods for the detection and quantifications of area-at-risk (AAR) in acute myocardial infarction (AMI) patients. However, CE-SSFP’s capacity for assessment of AAR at 3T has not been investigated. We examined the clinical utility of CE-SSFP and T2-STIR for the retrospective assessment of AAR at 3T with single-photon-emission-computed tomography (SPECT) validation.Materials and methodsA total of 60 AMI patients (ST-elevation AMI, n = 44;  non-ST-elevation AMI, n = 16) were recruited into the CMR study between 3 and 7 days post revascularization. All patients underwent T2-STIR, CE-bSSFP and late-gadolinium-enhancement CMR. For validation, SPECT images were acquired in a subgroup of patients (n = 30).ResultsIn 53 of 60 patients (88 %), T2-STIR was of diagnostic quality compared with 54 of 60 (90 %) with CE-SSFP. In a head-to-head per-slice comparison (n = 365), there was no difference in AAR quantified using T2-STIR and CE-SSFP (R2 = 0.92, p < 0.001; bias:-0.4 ± 0.8 cm2, p = 0.46). On a per-patient basis, there was good agreement between CE-SSFP (n = 29) and SPECT (R2 = 0.86, p < 0.001; bias: − 1.3 ± 7.8 %LV, p = 0.39) for AAR determination. T2-STIR also showed good agreement with SPECT for AAR measurement (R2 = 0.81, p < 0.001, bias: 0.5 ± 11.1 %LV, p = 0.81). There was also a strong agreement between CE-SSFP and T2-STIR with respect to the assessment of AAR on per-patient analysis (R2 = 0.84, p < 0.001, bias: − 2.1 ± 10.1 %LV, p = 0.31).ConclusionsAt 3T, both CE-SSFP and T2-STIR can retrospectively quantify the at-risk myocardium with high accuracy.
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38 schema:keywords AAR
39 AAR measurements
40 AMI patients
41 CE-SSFP
42 CMR
43 CMR studies
44 SPECT
45 SPECT images
46 T2-STIR
47 accuracy
48 acute myocardial infarction patients
49 agreement
50 alternative
51 analysis
52 area
53 assessment
54 basis
55 capacity
56 cardiovascular magnetic resonance
57 clinical utility
58 comparison
59 detection
60 determination
61 diagnostic quality
62 differences
63 enhancement CMR
64 good agreement
65 head
66 high accuracy
67 images
68 infarction patients
69 magnetic resonance
70 materials
71 measurements
72 method
73 methodsA total
74 myocardial infarction patients
75 myocardium
76 patient analysis
77 patient basis
78 patients
79 quality
80 quantification
81 quantification of areas
82 resonance
83 respect
84 retrospective assessment
85 revascularization
86 risk
87 risk myocardium
88 slice comparison
89 steady state free precession cardiovascular magnetic resonance
90 strong agreement
91 study
92 subgroup of patients
93 subgroups
94 total
95 utility
96 validation
97 valuable alternative
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