用于猪急性和慢性心肌梗死特征描述的原生 T 映射：与对比增强 MRI 的比较。
Native T mapping for characterization of acute and chronic myocardial infarction in swine: Comparison with contrast-enhanced MRI.
机构信息
Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.
Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.
出版信息
J Magn Reson Imaging. 2018 May;47(5):1406-1414. doi: 10.1002/jmri.25871. Epub 2017 Oct 16.
BACKGROUND
Both acute and chronic myocardial infarction (AMI and CMI, respectively) exhibit delayed enhancement; however, clinical decision-making processes frequently require the differentiation of these two types of myocardial injury.
PURPOSE
To investigate the reliability of AMI and CMI characterization using native T mapping and its feasibility for discriminating AMI from CMI.
STUDY TYPE
Case-control.
ANIMAL MODEL
The study cohort comprised 12 AMI (mean post-MI, 3.75 ± 1.29 days) and 15 CMI (mean post-MI, 39.53 ± 6.10 days) Bama mini-pigs.
FIELD STRENGTH/SEQUENCE: Balanced steady-state free precession (bSSFP), segmented-turbo-FLASH-PSIR, and modified Look-Locker inversion recovery (MOLLI) sequences at 3.0T.
ASSESSMENT
The infarct sizes were compared on matching short-axis slices of late-gadolinium-enhanced (LGE) images and T maps by two experienced radiologists.
STATISTICAL TESTS
The infarct sizes were compared on matching short-axis slices of LGE images and T maps, and agreement was determined using linear regression and Bland-Altman analyses. The native T values were compared between AMI and CMI models (independent sample t-test). The intraclass correlation coefficient was used to assess inter- and intraobserver variability.
RESULTS
Measured infarct sizes did not differ between native T mapping and LGE images (AMI: P = 0.913; CMI: P = 0.233), and good agreement was observed between the two techniques (AMI: bias, -3.38 ± 19.38%; R = 0.96; CMI: bias, -10.55 ± 10.90%; R = 0.90). However, the native infarction myocardium T values and the T signal intensity ratio of infarct and remote myocardium (T SI ratio) did not differ significantly between AMI and CMI (P = 0.173).
DATA CONCLUSION
Noncontrast native T mapping can accurately determine acute and chronic infarct areas as well as conventional LGE imaging; however, it cannot distinguish acute from chronic MI.
LEVEL OF EVIDENCE
1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1406-1414.
背景
急性和慢性心肌梗死（AMI 和 CMI）分别表现出延迟增强；然而，临床决策过程经常需要区分这两种类型的心肌损伤。
目的
利用原生 T 映射来研究 AMI 和 CMI 特征的可靠性及其区分 AMI 和 CMI 的可行性。
研究类型
病例对照。
动物模型
研究队列包括 12 例 AMI（平均心肌梗死后 3.75±1.29 天）和 15 例 CMI（平均心肌梗死后 39.53±6.10 天）巴马小型猪。
磁场强度/序列：3.0T 下的平衡稳态自由进动（bSSFP）、分段涡轮-FLASH-PSIR 和改良 Look-Locker 反转恢复（MOLLI）序列。
评估
两名有经验的放射科医生在晚期钆增强（LGE）图像和 T 图谱的匹配短轴切片上比较梗死大小。
统计检验
在 LGE 图像和 T 图谱的匹配短轴切片上比较梗死大小，并使用线性回归和 Bland-Altman 分析确定一致性。比较 AMI 和 CMI 模型之间的原生 T 值（独立样本 t 检验）。使用组内相关系数评估观察者内和观察者间的可变性。
结果
在原生 T 映射和 LGE 图像之间，测量的梗死大小没有差异（AMI：P=0.913；CMI：P=0.233），并且两种技术之间观察到良好的一致性（AMI：偏倚，-3.38±19.38%；R=0.96；CMI：偏倚，-10.55±10.90%；R=0.90）。然而，AMI 和 CMI 之间的原生梗死心肌 T 值和梗死与远侧心肌的 T 信号强度比（T SI 比）没有显著差异（P=0.173）。
数据结论
非对比原生 T 映射可以准确确定急性和慢性梗死区域，以及常规 LGE 成像；然而，它不能区分急性和慢性 MI。
证据水平
1 技术功效：第 2 阶段 J. Magn. Reson. Imaging 2018；47:1406-1414.
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