两种心脏磁共振成像水肿映射方法的性能：双对比快速自旋回波和T2准备平衡稳态自由进动

Performance of two Methods for Cardiac MRI Edema Mapping: Dual-Contrast Fast Spin-Echo and T2 Prepared Balanced Steady State Free Precession.

作者信息

Krumm Patrick, Martirosian Petros, Rath Dominik, Gawaz Meinrad, Nikolaou Konstantin, Klumpp Bernhard Daniel, Hornung Andreas, Kramer Ulrich, Schick Fritz, Geisler Tobias, Zitzelsberger Tanja

机构信息

Diagnostic and Interventional Radiology, University of Tübingen, Germany.

Section on Experimental Radiology, University of Tübingen, Germany.

出版信息

Rofo. 2020 Jul;192(7):669-677. doi: 10.1055/a-1088-3478. Epub 2020 Feb 4.

DOI:10.1055/a-1088-3478

PMID:32018303

Abstract

PURPOSE

To compare true positive and false negative results of myocardial edema mapping in two methods. Myocardial edema may be difficult to detect on cardiac MRI.

MATERIALS AND METHODS

76 patients (age 59 ± 11 years, 15 female) with acute myocardial infarction (MI) and 10 healthy volunteers were prospectively included in this single-center study. 1.5 T cardiac MRI was performed in patients 2.5 days after revascularization (median) for edema mapping: Steady State Free Precession (SSFP) mapping sequence with T-preparation pulses (Tprep); and dual-contrast Fast Spin-Echo (dcFSE) signal decay edema mapping. Late gadolinium enhancement (LGE) was used as the reference for expected edema in acute MI.

RESULTS

311 myocardial segments in patients were acutely infarcted with mean T 73 ms for Tprep SSFP vs. 87 ms for dcFSE edema mapping. In healthy volunteers the mean T was 56 ms for Tprep SSFP vs. 50 ms for dcFSE edema mapping. Receiver operating characteristic (ROC) curve for Tprep SSFP show area under the curve (AUC) 0.962, p < 0.0001, Youden index J 0.8266, associated criterion > 60 ms, sensitivity 94 %, specificity 89 %. dcFSE ROC AUC 0.979, p < 0.0001, J 0.9219, associated criterion > 64 ms, sensitivity 93 %, specificity 99 %.

CONCLUSION

Both edema mapping methods indicate high-grade edema with high sensitivity. Nevertheless, edema in acute infarction may be focally underestimated in both mapping methods.

KEY POINTS

· Sensitivity for edema detection is high for both methods.. · Edema may be focally underestimated by T2prep SSFP edema mapping and dcFSE mapping..

CITATION FORMAT

· Krumm P, Martirosian P, Rath D et al. Performance of two Methods for Cardiac MRI Edema Mapping: Dual-Contrast Fast Spin-Echo and T2 Prepared Balanced Steady State Free Precession. Fortschr Röntgenstr 2020; 192: 669 - 677.

摘要

目的

比较两种方法检测心肌水肿的真阳性和假阴性结果。心肌水肿在心脏磁共振成像（MRI）上可能难以检测。

材料与方法

本单中心研究前瞻性纳入了76例急性心肌梗死（MI）患者（年龄59±11岁，女性15例）和10名健康志愿者。患者在血运重建后2.5天（中位数）接受1.5T心脏MRI检查以进行水肿成像：采用T准备脉冲（Tprep）的稳态自由进动（SSFP）成像序列；以及双对比快速自旋回波（dcFSE）信号衰减水肿成像。延迟钆增强（LGE）用作急性心肌梗死中预期水肿的参考。

结果

患者的311个心肌节段发生急性梗死，Tprep SSFP的平均T值为73毫秒，而dcFSE水肿成像的平均T值为87毫秒。在健康志愿者中，Tprep SSFP的平均T值为56毫秒，而dcFSE水肿成像的平均T值为50毫秒。Tprep SSFP的受试者操作特征（ROC）曲线显示曲线下面积（AUC）为0.962，p<0.0001，约登指数J为0.8266，相关标准>60毫秒，敏感性为94%，特异性为89%。dcFSE的ROC AUC为0.979，p<0.0001，J为0.9219，相关标准>64毫秒，敏感性为93%，特异性为99%。