Dewey Marc, Laule Michael, Taupitz Matthias, Kaufels Nicola, Hamm Bernd, Kivelitz Dietmar
Department of Radiology, Charité, Medical School, Humboldt-Universität zu Berlin, Schumannstrasse 20/21, 10117 Berlin, Germany.
Radiology. 2006 Jun;239(3):703-9. doi: 10.1148/radiol.2393050586. Epub 2006 Apr 26.
To prospectively evaluate the correlation between a three-dimensional (3D) delayed enhancement magnetic resonance (MR) imaging sequence and a two-dimensional (2D) delayed enhancement MR imaging sequence for noninvasive assessment of myocardial viability in pigs and patients.
The pig and patient studies were approved by the responsible authorities, and patients gave written informed consent. MR imaging was performed by using a rapid 3D inversion-recovery balanced steady-state free precession sequence and a 2D segmented inversion-recovery fast low-angle shot sequence as the reference standard. Fourteen pigs with reperfused (n=7) or nonreperfused (n=7) myocardial infarction and 17 patients (13 men, four women; mean age, 64.9 years+/-8.6 [standard deviation]) suspected of having myocardial infarction were included. Linear regression analysis and Bland-Altman analysis were used to compare the infarction volumes.
In 10 of the 14 pigs the induction of myocardial infarction was successful. In these pigs, altogether 81 segments with myocardial infarction were demonstrated by both MR sequences, and agreement between the two sequences for classification of transmural extent of myocardial infarction was 99.7%. The infarction volume determined by using 3D MR imaging (4.64 cm3+/-2.48) in the pigs highly correlated with that of 2D MR imaging (4.65 cm3+/-2.39, r=0.989, P<.001) and that of staining by using triphenyltetrazolium chloride (4.67 cm3+/-2.44, r=0.996, P<.001). Thirteen of the 17 patients examined showed myocardial infarction in 34 myocardial segments with both sequences, and agreement between the two sequences for classification of transmural extent of myocardial infarction was 98.6%. In the patients, the infarction volume determined with both sequences highly correlated (9.71 cm3+/-7.47 for the 3D sequence vs 10.01 cm3+/-8.04 for the 2D sequence, r=0.982, P<.001). The breath-hold time necessary for the 3D MR imaging (21.0+/-2.3 seconds) was significantly shorter than that for 2D MR imaging (188.3+/-20.2 seconds, P<.001).
Myocardial infarction volumes obtained with the 3D MR imaging sequence are highly correlated and in good agreement with volumes obtained with the 2D MR imaging standard approach and reduced the acquisition time by a factor of nine.
前瞻性评估三维（3D）延迟增强磁共振（MR）成像序列与二维（2D）延迟增强MR成像序列在无创评估猪和患者心肌存活方面的相关性。
猪和患者研究均获相关部门批准，患者签署了书面知情同意书。采用快速3D反转恢复平衡稳态自由进动序列及2D分段反转恢复快速低角度激发序列作为参考标准进行MR成像。纳入14只发生再灌注（n = 7）或未再灌注（n = 7）心肌梗死的猪，以及17例疑似心肌梗死的患者（13例男性，4例女性；平均年龄64.9岁±8.6[标准差]）。采用线性回归分析和Bland-Altman分析比较梗死体积。
14只猪中有10只成功诱导出心肌梗死。在这些猪中，两种MR序列共显示81个心肌梗死节段，两种序列在心肌梗死透壁范围分类上的一致性为99.7%。猪中用3D MR成像测定的梗死体积（4.64 cm³±2.48）与2D MR成像测定的梗死体积（4.65 cm³±2.39，r = 0.989，P <.001）以及用氯化三苯基四氮唑染色测定的梗死体积（4.67 cm³±2.44，r = 0.996，P <.001）高度相关。17例接受检查的患者中有13例在34个心肌节段显示心肌梗死，两种序列在心肌梗死透壁范围分类上的一致性为98.6%。在患者中，两种序列测定的梗死体积高度相关（3D序列为9.71 cm³±7.47，2D序列为10.01 cm³±8.04，r = 0.982，P <.001）。3D MR成像所需的屏气时间（21.0±2.3秒）明显短于2D MR成像所需的屏气时间（188.3±20.2秒，P <.001）。
3D MR成像序列获得的心肌梗死体积与2D MR成像标准方法获得的体积高度相关且一致性良好，采集时间缩短了九倍。
