Green Jordin D, Clarke James R, Flewitt Jacqueline A, Friedrich Matthias G
Siemens Healthcare, Calgary, Alberta.
J Magn Reson Imaging. 2009 Sep;30(3):690-5. doi: 10.1002/jmri.21868.
To demonstrate the ability of single-shot, T(2)/T(1) weighted steady-state free precession (SSFP) to detect myocardial edema in patients with an acute myocardial infarction.
This study was performed in a series of patients (n = 10) referred for the assessment of acute myocardial infarcts (AMI). Localizers were used to obtain true short axis views of the left ventricle (LV). These views were used to plan and obtain T(2)-weighted STIR (short TI inversion recovery) images of the LV. These slices were then acquired using single-shot dark blood-prepared SSFP with a large (31) number of dummy pulses. Lastly, Contrast agent was injected, and late enhancement (LE) images were acquired. Images were analyzed using a multi-segment model of the heart. SSFP images were compared with STIR images, with STIR images used as the standard of truth for the presence of edema. LE images were used to identify segments which were positive for microvascular obstruction.
All techniques were successful in all patients. A total of 312 segments were analyzed. Excluding segments positive for microvascular obstruction, SSFP had a sensitivity/specificity of 80%/89%. Including segments positive for microvascular obstruction, sensitivity/specificity was 71%/88%. On a patient-based analysis, no AMI was missed using SSFP (sensitivity = 100%).
Using single-shot SSFP to detect myocardial edema in patients with AMI is feasible with a moderate sensitivity and high specificity.
证明单次激发的T(2)/T(1)加权稳态自由进动(SSFP)检测急性心肌梗死患者心肌水肿的能力。
本研究对一系列因评估急性心肌梗死(AMI)而转诊的患者(n = 10)进行。使用定位像获取左心室(LV)的真正短轴视图。这些视图用于规划并获取LV的T(2)加权STIR(短TI反转恢复)图像。然后使用具有大量(31个)伪脉冲的单次激发黑血准备的SSFP采集这些层面图像。最后，注射造影剂并采集延迟强化(LE)图像。使用心脏多节段模型分析图像。将SSFP图像与STIR图像进行比较，以STIR图像作为水肿存在与否的真实标准。LE图像用于识别微血管阻塞阳性的节段。
所有技术在所有患者中均成功。共分析了312个节段。排除微血管阻塞阳性节段后，SSFP的敏感性/特异性为80%/89%。包括微血管阻塞阳性节段后，敏感性/特异性为71%/88%。基于患者的分析中，使用SSFP未漏诊任何AMI(敏感性 = 100%)。
使用单次激发SSFP检测AMI患者的心肌水肿是可行的，具有中等敏感性和高特异性。
