Department of Cardiology in Linköping, Linköping University, Linköping, Sweden.
Unit of Cardiovascular Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
J Magn Reson Imaging. 2022 Nov;56(5):1393-1403. doi: 10.1002/jmri.28100. Epub 2022 Feb 7.
Epicardial adipose tissue (EAT) may induce left atrium (LA) wall inflammation and promote LA fibrosis. Therefore, simultaneous assessment of these two important atrial fibrillation (AF) risk factors would be desirable.
To perform a comprehensive evaluation of 3D Dixon water-fat separated late gadolinium enhancement (LGE-Dixon) MRI by analysis of repeatability and systematic comparison with reference methods for assessment of fibrosis and fat.
Prospective.
Twenty-eight, 10, and 7 patients, respectively, with clinical indications for cardiac MRI.
FIELD STRENGTH/SEQUENCE: A 1.5-T scanner, inversion recovery multiecho spoiled gradient echo.
Twenty-eight patients (age 58 ± 19 years, 15 males) were scanned using LGE-Dixon. A 5-point Likert-type scale was used to grade the image quality. Another 10 patients (age 46 ± 19 years, 9 males) were scanned using LGE-Dixon and 3D proton density Dixon (PD-Dixon). Finally, seven patients (age 62 ± 14 years, 4 males) were scanned using LGE-Dixon and conventional LGE. The scan time, intraobserver and interobserver variability, and levels of agreement were assessed.
Student's t-test, one-way ANOVA, and Mann-Whitney U-test were used; P < 0.05 was considered significant, intraclass correlation coefficient (ICC).
The scan time (minutes:seconds) for LGE-Dixon (n = 28) was 5:01 ± 1:40. ICC values for intraobserver and interobserver measurements of LA wall fibrosis percentage were 0.98 (95% CI, 0.97-0.99) and 0.97 (95% CI, 0.94-0.99) while of EAT were 0.92 (95% CI, 0.82-0.97) and 0.90 (95% CI, 0.80-0.95). The agreement for LA fibrosis percentage between the LGE-Dixon and the conventional LGE was 0.92 (95% CI, 0.66-0.99) and for EAT volume between the LGE-Dixon and the PD-Dixon was 0.93 (95% CI, 0.72-0.98).
LA fibrosis and EAT can be assessed simultaneously using LGE-Dixon. This method allows a high level of intraobserver and interobserver repeatability as well as agreement with reference methods and can be performed in a clinically feasible scan time.
2 TECHNICAL EFFICACY STAGE: 3.
心外膜脂肪组织（EAT）可能会引起左心房（LA）壁炎症并促进 LA 纤维化。因此，同时评估这两个重要的心房颤动（AF）危险因素将是理想的。
通过对 3D Dixon 水脂分离延迟钆增强（LGE-Dixon）MRI 的重复性进行全面评估，并与参考方法进行系统比较，评估纤维化和脂肪。
前瞻性。
分别有 28、10 和 7 名患者，分别有心脏 MRI 的临床指征。
磁场强度/序列：1.5-T 扫描仪，反转恢复多回波扰相梯度回波。
28 名患者（年龄 58±19 岁，15 名男性）接受了 LGE-Dixon 扫描。使用 5 分李克特量表对图像质量进行分级。另外 10 名患者（年龄 46±19 岁，9 名男性）接受了 LGE-Dixon 和 3D 质子密度 Dixon（PD-Dixon）扫描。最后，7 名患者（年龄 62±14 岁，4 名男性）接受了 LGE-Dixon 和常规 LGE 扫描。评估了扫描时间、观察者内和观察者间的可重复性以及一致性水平。
使用学生 t 检验、单因素方差分析和曼-惠特尼 U 检验；P<0.05 被认为具有统计学意义，组内相关系数（ICC）。
LGE-Dixon（n=28）的扫描时间（分钟：秒）为 5:01±1:40。LA 壁纤维化百分比的观察者内和观察者间测量的 ICC 值分别为 0.98（95%CI，0.97-0.99）和 0.97（95%CI，0.94-0.99），EAT 的 ICC 值分别为 0.92（95%CI，0.82-0.97）和 0.90（95%CI，0.80-0.95）。LA 纤维化百分比在 LGE-Dixon 和常规 LGE 之间的一致性为 0.92（95%CI，0.66-0.99），EAT 体积在 LGE-Dixon 和 PD-Dixon 之间的一致性为 0.93（95%CI，0.72-0.98）。
LGE-Dixon 可同时评估 LA 纤维化和 EAT。该方法允许观察者内和观察者间具有较高的可重复性以及与参考方法的一致性，并且可以在临床可行的扫描时间内完成。
2 技术功效阶段：3
