腺苷负荷心脏磁共振心肌灌注成像在非缺血性扩张型心肌病患者中的高重复性。

High reproducibility of adenosine stress cardiac MR myocardial perfusion imaging in patients with non-ischaemic dilated cardiomyopathy.

机构信息

Division of Cardiovascular Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

出版信息

BMJ Open. 2014 Dec 16;4(12):e005984. doi: 10.1136/bmjopen-2014-005984.

DOI:10.1136/bmjopen-2014-005984

PMID:25515841

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4275661/

Abstract

OBJECTIVE

To evaluate the reproducibility of first-pass contrast-enhanced cardiac MR (CMR) myocardial perfusion imaging in patients with non-ischaemic dilated cardiomyopathy (NIDCM).

DESIGN

Prospective observational study.

SETTING

Single centre, tertiary care hospital.

PARTICIPANTS

6 outpatient participants with NIDCM.

OUTCOME

Reproducibility of semiquantitative myocardial perfusion analysis by CMR.

METHOD

6 patients with NIDCM were studied twice using first-pass of contrast transit through the left ventricular (LV) myocardium with a saturation-recovery gradient echo sequence at rest and during adenosine-induced hyperaemia. The anterior wall was divided into endocardial (Endo) and epicardial (Epi) segments. The Myocardial Perfusion Index (MPI) was calculated as the myocardial signal augmentation rate normalised to the LV cavity rate. The Myocardial Perfusion Reserve Index (MPRI) was calculated as hyperaemic/resting MPI.

RESULTS

Between study 1 and 2, median MPI was similar for resting Endo (0.076 vs 0.077), hyperaemic Endo (0.143 vs 0.143), resting Epi (0.073 vs 0.074), and hyperaemic Epi (0.135 vs 0.134). Median MPRI was similar for Endo (1.84 vs 1.87) and Epi (1.90 vs 2.00). Combining Endo and Epi MPI (N=12), there was excellent agreement between Study 1 and 2 for resting MPI (r=0.998, intraclass correlation coefficient (ICC) 0.998, coefficients of variation (CoV) 1.4%), hyperaemic MPI (r=0.979, ICC 0.963, CoV 3.3%) and MPRI (r=0.989, ICC 0.94, CoV 3.8%).

CONCLUSIONS

Resting and hyperaemic myocardial perfusion using a normalised upslope analysis during adenosine CMR is a highly reproducible technique in patients with NIDCM.

TRIAL REGISTRATION NUMBER

Clinical Trials.Gov ID NCT00574119.

摘要

目的

评估非缺血性扩张型心肌病（NIDCM）患者初次通过对比增强心脏磁共振（CMR）心肌灌注成像的可重复性。

设计

前瞻性观察性研究。

地点

单中心，三级保健医院。

参与者

6 名 NIDCM 门诊患者。

结果

CMR 半定量心肌灌注分析的可重复性。

方法

6 例 NIDCM 患者在休息和腺苷诱导的充血期间使用左心室（LV）心肌对比通过的初次通过使用饱和恢复梯度回波序列进行两次研究。前壁分为心内膜（Endo）和心外膜（Epi）节段。心肌灌注指数（MPI）计算为心肌信号增强率与 LV 腔率的归一化。心肌灌注储备指数（MPRI）计算为充血/休息 MPI。

结果

在研究 1 和 2 之间，静息 Endo（0.076 与 0.077）、充血 Endo（0.143 与 0.143）、静息 Epi（0.073 与 0.074）和充血 Epi（0.135 与 0.134）的中位数 MPI 相似。Endo（1.84 与 1.87）和 Epi（1.90 与 2.00）的中位数 MPRI 相似。在 12 例联合 Endo 和 Epi MPI 中，静息 MPI（r=0.998，组内相关系数（ICC）0.998，变异系数（CoV）1.4%）、充血 MPI（r=0.979，ICC 0.963，CoV 3.3%）和 MPRI（r=0.989，ICC 0.94，CoV 3.8%）在研究 1 和 2 之间具有极好的一致性。