回顾性评估 3T 下对比增强平衡稳态自由进动心血管磁共振与 SPECT 验证对再灌注急性心肌梗死患者的易损心肌。

Retrospective assessment of at-risk myocardium in reperfused acute myocardial infarction patients using contrast-enhanced balanced steady-state free-precession cardiovascular magnetic resonance at 3T with SPECT validation.

机构信息

Department of Radiology, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China.

Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.

出版信息

J Cardiovasc Magn Reson. 2021 Mar 15;23(1):25. doi: 10.1186/s12968-021-00730-7.

BACKGROUND

Contrast-enhanced (CE) steady-state free precession (SSFP) CMR at 1.5T has been shown to be a valuable alternative to T2-based methods for the detection and quantifications of area-at-risk (AAR) in acute myocardial infarction (AMI) patients. However, CE-SSFP's capacity for assessment of AAR at 3T has not been investigated. We examined the clinical utility of CE-SSFP and T2-STIR for the retrospective assessment of AAR at 3T with single-photon-emission-computed tomography (SPECT) validation.

MATERIALS AND METHODS

A total of 60 AMI patients (ST-elevation AMI, n = 44; non-ST-elevation AMI, n = 16) were recruited into the CMR study between 3 and 7 days post revascularization. All patients underwent T2-STIR, CE-bSSFP and late-gadolinium-enhancement CMR. For validation, SPECT images were acquired in a subgroup of patients (n = 30).

RESULTS

In 53 of 60 patients (88 %), T2-STIR was of diagnostic quality compared with 54 of 60 (90 %) with CE-SSFP. In a head-to-head per-slice comparison (n = 365), there was no difference in AAR quantified using T2-STIR and CE-SSFP (R = 0.92, p < 0.001; bias:-0.4 ± 0.8 cm, p = 0.46). On a per-patient basis, there was good agreement between CE-SSFP (n = 29) and SPECT (R = 0.86, p < 0.001; bias: - 1.3 ± 7.8 %LV, p = 0.39) for AAR determination. T2-STIR also showed good agreement with SPECT for AAR measurement (R = 0.81, p < 0.001, bias: 0.5 ± 11.1 %LV, p = 0.81). There was also a strong agreement between CE-SSFP and T2-STIR with respect to the assessment of AAR on per-patient analysis (R = 0.84, p < 0.001, bias: - 2.1 ± 10.1 %LV, p = 0.31).

CONCLUSIONS

At 3T, both CE-SSFP and T2-STIR can retrospectively quantify the at-risk myocardium with high accuracy.

背景

在 1.5T 下，对比增强（CE）稳态自由进动（SSFP）CMR 已被证明是一种有价值的替代方法，可以用于检测和量化急性心肌梗死（AMI）患者的危险区（AAR）。然而，CE-SSFP 在 3T 下评估 AAR 的能力尚未得到研究。我们使用单光子发射计算机断层扫描（SPECT）进行验证，研究了 CE-SSFP 和 T2-STIR 在 3T 下用于回顾性评估 AAR 的临床应用价值。

材料和方法

共有 60 名 AMI 患者（ST 段抬高型 AMI，n=44；非 ST 段抬高型 AMI，n=16）在血管重建后 3-7 天内被纳入 CMR 研究。所有患者均进行 T2-STIR、CE-bSSFP 和晚期钆增强 CMR。在亚组患者（n=30）中获取 SPECT 图像进行验证。

结果

在 60 名患者中的 53 名（88%）中，T2-STIR 的质量可用于诊断，而在 60 名患者中的 54 名（90%）中，CE-SSFP 的质量可用于诊断。在头对头的每片比较（n=365）中，使用 T2-STIR 和 CE-SSFP 定量的 AAR 没有差异（R=0.92，p<0.001；偏差：-0.4±0.8cm，p=0.46）。在基于患者的基础上，CE-SSFP（n=29）与 SPECT 之间有良好的一致性（R=0.86，p<0.001；偏差：-1.3±7.8%LV，p=0.39），用于确定 AAR。T2-STIR 也与 SPECT 对 AAR 测量有良好的一致性（R=0.81，p<0.001，偏差：0.5±11.1%LV，p=0.81）。在基于患者的分析中，CE-SSFP 和 T2-STIR 对 AAR 的评估也有很强的一致性（R=0.84，p<0.001，偏差：-2.1±10.1%LV，p=0.31）。