使用心血管磁共振应力T1映射检测心肌缺血：一项小型猪验证研究。
Detection of Myocardial Ischemia Using Cardiovascular MRI Stress T1 Mapping: A Miniature-Swine Validation Study.
作者信息
Zhuang Baiyan, Cui Chen, He Jian, Xu Jing, Yin Gang, Duan Xuejing, Yue Guangxin, Wang Hongyue, Wang Xin, Sirajuddin Arlene, Zhao Shihua, Lu Minjie
机构信息
From the Department of Magnetic Resonance Imaging, Cardiovascular Imaging and Intervention Center (B.Z., C.C., J.H., J.X., G.Y., S.Z., M.L.), Department of Pathology (X.D., H.W.), and Department of Animal Experimental Center (G.Y., X.W.), Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, People's Republic of China; National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Md (A.S., M.L.); and Key Laboratory of Cardiovascular Imaging (Cultivation), Chinese Academy of Medical Sciences, Beijing, People's Republic of China (M.L.).
出版信息
Radiol Cardiothorac Imaging. 2023 Jun 22;5(3):e220092. doi: 10.1148/ryct.220092. eCollection 2023 Jun.
PURPOSE
To assess the efficacy of cardiac MRI stress T1 mapping in detecting ischemic and infarcted myocardium in a miniature-swine model, using pathologic findings as the reference standard.
MATERIALS AND METHODS
Ten adult male Chinese miniature swine, with coronary artery stenosis induced by an ameroid constrictor, and two healthy control swine were studied. Cardiac 3-T MRI rest and adenosine triphosphate stress T1 mapping and perfusion images, along with resting and late gadolinium enhancement images, were acquired at baseline and weekly up to 4 weeks after surgery or until humanely killed. A receiver operating characteristic analysis was used to analyze the performance of T1 mapping in the detection of myocardial ischemia.
RESULTS
In the experimental group, both the infarcted myocardium (ΔT1 = 10 msec ± 2 [SD]; ΔT1 percentage = 0.7% ± 0.1) and ischemic myocardium (ΔT1 = 10 msec ± 2; ΔT1 percentage = 0.9% ± 0.2) exhibited reduced T1 reactivity compared with the remote myocardium (ΔT1 = 53 msec ± 7; ΔT1 percentage = 4.7% ± 0.6) and normal myocardium (ΔT1 = 56 msec ± 11; ΔT1 percentage = 4.9% ± 1.1). Receiver operating characteristic analysis demonstrated high diagnostic performance of ΔT1 in detecting ischemic myocardium, with an area under the curve (AUC) of 0.84 ( < .001). Rest T1 displayed high diagnostic performance in detecting infarcted myocardium (AUC = 0.95; < .001). When rest T1 and ΔT1 were combined, the diagnostic performance for both ischemic and infarcted myocardium were improved (AUCs, 0.89 and 0.97, respectively; all < .001). The collagen volume fraction correlated with ΔT1, ΔT1 percentage, and Δ extracellular volume percentage ( = -0.70, -0.70, and -0.50, respectively; = .001, .001, and .03, respectively).
CONCLUSION
Using histopathologic validation in a swine model, noninvasive cardiac MRI stress T1 mapping demonstrated high performance in detecting ischemic and infarcted myocardium without the need for contrast agents. Coronary Artery Disease, MRI, Myocardial Ischemia, Rest T1 Mapping, Stress T1 Mapping, Swine Model © RSNA, 2023See also commentary by Burrage and Ferreira in this issue.
目的
以病理结果作为参考标准，评估心脏磁共振成像（MRI）应力T1映射在小型猪模型中检测缺血和梗死心肌的效能。
材料与方法
对10只成年雄性中国小型猪进行研究，这些猪通过阿霉素缩窄器诱导冠状动脉狭窄，另有2只健康对照猪。在基线时以及术后每周直至4周或直至实施安乐死，采集心脏3-T MRI静息和三磷酸腺苷应激T1映射及灌注图像，以及静息和延迟钆增强图像。采用受试者操作特征分析来分析T1映射在检测心肌缺血方面的性能。
结果
在实验组中，与远隔心肌（ΔT1 = 53毫秒±7；ΔT1百分比 = 4.7%±0.6）和正常心肌（ΔT1 = 56毫秒±11；ΔT1百分比 = 4.9%±1.1）相比，梗死心肌（ΔT1 = 10毫秒±2 [标准差]；ΔT1百分比 = 0.7%±0.1）和缺血心肌（ΔT1 = 10毫秒±2；ΔT1百分比 = 0.9%±0.2）的T1反应性均降低。受试者操作特征分析表明，ΔT1在检测缺血心肌方面具有较高的诊断性能，曲线下面积（AUC）为0.84（P <.001）。静息T1在检测梗死心肌方面具有较高的诊断性能（AUC = 0.95；P <.001）。当将静息T1和ΔT1结合使用时，对缺血和梗死心肌的诊断性能均得到改善（AUC分别为0.89和0.97；均P <.001）。胶原体积分数与ΔT1、ΔT1百分比和细胞外容积变化百分比相关（分别为r = -0.70、-0.70和-0.50；P分别为.001、.001和.03）。
结论
在猪模型中采用组织病理学验证，无创性心脏MRI应力T1映射在检测缺血和梗死心肌方面表现出高性能，且无需使用造影剂。冠状动脉疾病、MRI、心肌缺血、静息T1映射、应力T1映射、猪模型 © RSNA，2023另见本期Burrage和Ferreira的评论。
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