Everaars Henk, van Diemen Pepijn A, Biesbroek P Stefan, Hopman Luuk H G A, Bom Michiel J, Schumacher Stefan P, de Winter Ruben W, van de Ven Peter M, Raijmakers Pieter G, Lammertsma Adriaan A, Hofman Mark B M, Nijveldt Robin, Götte Marco J, van Rossum Albert C, Danad Ibrahim, Driessen Roel S, Knaapen Paul
Department of Cardiology, Amsterdam University Medical Centers, Vrije Universiteit, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers, Vrije Universiteit, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
Eur Heart J Cardiovasc Imaging. 2022 Jan 24;23(2):229-237. doi: 10.1093/ehjci/jeab073.
To compare cardiac magnetic resonance (CMR) measurement of T1 reactivity (ΔT1) with [15O]H2O positron emission tomography (PET) measurements of quantitative myocardial perfusion.
Forty-three patients with suspected obstructed coronary artery disease underwent [15O]H2O PET and CMR at 1.5-T, including rest and adenosine stress T1 mapping (ShMOLLI) and late gadolinium enhancement to rule out presence of scar tissue. ΔT1 was determined for the three main vascular territories and compared with [15O]H2O PET-derived regional stress myocardial blood flow (MBF) and myocardial flow reserve (MFR). ΔT1 showed a significant but poor correlation with stress MBF (R2 = 0.04, P = 0.03) and MFR (R2 = 0.07, P = 0.004). Vascular territories with impaired stress MBF (i.e. ≤2.30 mL/min/g) demonstrated attenuated ΔT1 compared with vascular territories with preserved stress MBF (2.9 ± 2.2% vs. 4.1 ± 2.2%, P = 0.008). In contrast, ΔT1 did not differ between vascular territories with impaired (i.e. <2.50) and preserved MFR (3.2 ± 2.6% vs. 4.0 ± 2.1%, P = 0.25). Receiver operating curve analysis of ΔT1 resulted in an area under the curve of 0.66 [95% confidence interval (CI): 0.57-0.75, P = 0.009] for diagnosing impaired stress MBF and 0.62 (95% CI: 0.53-0.71, P = 0.07) for diagnosing impaired MFR.
CMR stress T1 mapping has poor agreement with [15O]H2O PET measurements of absolute myocardial perfusion. Stress T1 and ΔT1 are lower in vascular territories with reduced stress MBF but have poor accuracy for detecting impaired myocardial perfusion.
比较心脏磁共振成像（CMR）测量的T1反应性（ΔT1）与[15O]H2O正电子发射断层扫描（PET）测量的定量心肌灌注。
43例疑似冠状动脉疾病患者接受了1.5-T的[15O]H2O PET和CMR检查，包括静息和腺苷负荷T1映射（ShMOLLI）以及延迟钆增强以排除瘢痕组织的存在。测定三个主要血管区域的ΔT1，并与[15O]H2O PET衍生的区域负荷心肌血流量（MBF）和心肌血流储备（MFR）进行比较。ΔT1与负荷MBF（R2 = 0.04，P = 0.03）和MFR（R2 = 0.07，P = 0.004）呈显著但较弱的相关性。与负荷MBF正常的血管区域相比，负荷MBF受损（即≤2.30 mL/min/g）的血管区域ΔT1减弱（2.9±2.2%对4.1±2.2%，P = 0.008）。相比之下，MFR受损（即<2.50）和正常的血管区域之间的ΔT1没有差异（3.2±2.6%对4.0±2.1%，P = 0.25）。对ΔT1进行的受试者工作特征曲线分析显示，诊断负荷MBF受损时曲线下面积为0.66 [95%置信区间（CI）：0.57 - 0.75，P = 0.009]，诊断MFR受损时曲线下面积为0.62（95% CI：0.53 - 0.71，P = 0.07）。
CMR负荷T1映射与[15O]H2O PET测量的绝对心肌灌注一致性较差。负荷T1和ΔT1在负荷MBF降低的血管区域较低，但检测心肌灌注受损的准确性较差。
