基于早期 T1 定量合成映射的准确晚期钆增强预测。
Accurate late gadolinium enhancement prediction by early T1- based quantitative synthetic mapping.
机构信息
University of Groningen, University Medical Centre Groningen, Centre for Medical Imaging, Groningen, The Netherlands.
Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
出版信息
Eur Radiol. 2018 Feb;28(2):844-850. doi: 10.1007/s00330-017-5018-2. Epub 2017 Aug 30.
OBJECTIVES
Early synthetic gadolinium enhancement (ESGE) imaging from post-contrast T1 mapping after adenosine stress-perfusion cardiac magnetic resonance (CMR) was compared to conventional late gadolinium enhancement (LGE) imaging for assessing myocardial scar.
METHODS
Two hundred fourteen consecutive patients suspected of myocardial ischaemia were referred for stress-perfusion CMR. Myocardial infarct volume was quantified on a per-subsegment basis in both synthetic (2-3 min post-gadolinium) and conventional (9 min post-gadolinium) images by two independent observers. Sensitivity, specificity, PPV and NPV were calculated on a per-patient and per-subsegment basis.
RESULTS
Both techniques detected 39 gadolinium enhancement areas in 23 patients. The median amount of scar was 2.0 (1.0-3.1) g in ESGE imaging and 2.2 (1.1-3.1) g in LGE imaging (p=0.39). Excellent correlation (r=0.997) and agreement (mean absolute difference: -0.028±0.289 ml) were found between ESGE and LGE images. Sensitivity, specificity, PPV and NPV of ESGE imaging were 96 (78.9-99.9), 99 (97.1-100.0)%, 96 (76.5-99.4) and 99.5 (96.6-99.9) in patient-based and 99 (94.5-100.0), 100 (99.9-100.0)%, 97.0 (91.3-99.0) and 100.0 (99.8-100.0) in subsegment-based analysis.
CONCLUSION
ESGE based on post-contrast T1 mapping after adenosine stress-perfusion CMR imaging shows excellent agreement with conventional LGE imaging for assessing myocardial scar, and can substantially shorten clinical acquisition time.
KEY POINTS
• Synthetic gadolinium enhancement images can be used for detection of myocardial scar. • Early synthetic gadolinium enhancement images can substantially shorten clinical acquisition time. • ESGE has high diagnostic accuracy as compared to conventional late gadolinium enhancement. • Quantification of myocardial scar with ESGE closely correlates with conventional LGE. • ESGE after stress perfusion CMR avoids need for additional gadolinium administration.
目的
对比腺苷负荷后钆增强 T1 mapping 早期合成增强（ESGE）成像与常规晚期钆增强（LGE）成像，评估心肌瘢痕。
方法
214 例疑似心肌缺血的连续患者接受了负荷灌注心脏磁共振（CMR）检查。两位独立观察者基于每亚节段，在合成（钆增强后 2-3 分钟）和常规（钆增强后 9 分钟）图像上量化心肌梗死容积。基于个体和每亚节段计算敏感性、特异性、阳性预测值和阴性预测值。
结果
两种技术在 23 例患者中均检测到 39 个钆增强区域。ESGE 成像中瘢痕中位数为 2.0（1.0-3.1）g，LGE 成像中为 2.2（1.1-3.1）g（p=0.39）。ESGE 和 LGE 图像之间存在极好的相关性（r=0.997）和一致性（平均绝对差值：-0.028±0.289 ml）。ESGE 成像的敏感性、特异性、阳性预测值和阴性预测值在个体基础上分别为 96（78.9-99.9）、99（97.1-100.0）%、96（76.5-99.4）和 99.5（96.6-99.9），在亚节段基础上分别为 99（94.5-100.0）、100（100.0-100.0）%、97.0（91.3-99.0）和 100.0（99.8-100.0）%。
结论
基于腺苷负荷后钆增强 T1 映射的 ESGE 成像在评估心肌瘢痕方面与常规 LGE 成像具有极好的一致性，并可大大缩短临床采集时间。
关键点
• 合成增强图像可用于检测心肌瘢痕。
• 早期合成增强图像可大大缩短临床采集时间。
• ESGE 诊断准确性优于常规晚期增强。
• ESGE 对心肌瘢痕的定量与常规 LGE 密切相关。
• 应激灌注 CMR 后 ESGE 避免了额外的钆剂给药。
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