在植入心脏设备的患者中，使用自由呼吸运动校正宽带黑血延迟钆增强成像改善心肌瘢痕可视化。
Improved myocardial scar visualization using free-breathing motion-corrected wideband black-blood late gadolinium enhancement imaging in patients with implantable cardiac devices.
作者信息
Gut Pauline, Cochet Hubert, Antiochos Panagiotis, Caluori Guido, Durand Baptiste, Constantin Marion, Vlachos Konstantinos, Narceau Kalvin, Masi Ambra, Schwitter Jürg, Sacher Frederic, Jaïs Pierre, Stuber Matthias, Bustin Aurélien
机构信息
IHU LIRYC, Heart Rhythm Disease Institute, Université de Bordeaux, INSERM U1045, 33604, Pessac, France; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; Faculty of Biology and Medicine, University of Lausanne, 1011 Lausanne, Switzerland.
Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, 33604 Pessac, France.
出版信息
Diagn Interv Imaging. 2025 May;106(5):169-182. doi: 10.1016/j.diii.2024.12.001. Epub 2024 Dec 12.
PURPOSE
The purpose of this study was to introduce and evaluate a novel 2D wideband black-blood (BB) LGE sequence, incorporating wideband inversion recovery, wideband T2 preparation, and non-rigid motion correction (MOCO) reconstruction, to improve myocardial scar detection and address artifacts associated with implantable cardioverter defibrillators (ICDs).
MATERIALS AND METHODS
The wideband MOCO free-breathing BB-LGE sequence was tested on a sheep with ischemic scar and in 22 patients with cardiac disease, including 15 with cardiac implants, at 1.5T. Wideband MOCO free-breathing BB-LGE sequence was compared with conventional and wideband breath-held PSIR-LGE and conventional and wideband breath-held BB-LGE techniques. Image sharpness, entropy, and scar-to-blood, scar-to-myocardium, and blood-to-myocardium contrast were analyzed and reconstruction times were measured. Two expert readers assessed the image quality, ICD artifact severity, and the diagnostic confidence with scar extent. Finally, for the animal study, a histology of the heart was performed to confirm the presence and localization of scar tissue.
RESULTS
In the animal, wideband MOCO free-breathing BB-LGE were reconstructed in 0.6 s and demonstrated a 200 % improvement in scar-to-blood contrast compared to wideband breath-held PSIR-LGE, with significant improvement in image sharpness and reduction in entropy. It also effectively minimized ICD artifacts and accurately detected scars. In patients, wideband MOCO free-breathing BB-LGE were reconstructed in 1.5 ± 0.4 (standard deviation) s per slice. Seventeen patients (17/22; 77%) with myocardial scars were confidently diagnosed with wideband MOCO free-breathing BB-LGE, compared to 11 (11/22; 50 %) with wideband breath-held PSIR-LGE (P < 0.01).
CONCLUSION
Free-breathing wideband T2-prepared black-blood LGE imaging, combined with motion-corrected reconstruction, offers a promising diagnostic approach for the evaluation of myocardial lesions in patients with ICDs.
目的
本研究旨在引入并评估一种新型二维宽带黑血（BB）延迟增强（LGE）序列，该序列结合了宽带反转恢复、宽带T2准备和非刚性运动校正（MOCO）重建，以改善心肌瘢痕检测并解决与植入式心脏复律除颤器（ICD）相关的伪影。
材料与方法
在一只患有缺血性瘢痕的绵羊和22例心脏病患者（包括15例植入心脏装置的患者）中，于1.5T条件下测试宽带MOCO自由呼吸BB-LGE序列。将宽带MOCO自由呼吸BB-LGE序列与传统和宽带屏气PSIR-LGE以及传统和宽带屏气BB-LGE技术进行比较。分析图像清晰度、熵以及瘢痕与血液、瘢痕与心肌、血液与心肌之间的对比度，并测量重建时间。两名专业阅片者评估图像质量、ICD伪影严重程度以及对瘢痕范围的诊断信心。最后，在动物研究中，对心脏进行组织学检查以确认瘢痕组织的存在和定位。
结果
在动物实验中，宽带MOCO自由呼吸BB-LGE序列的重建时间为0.6秒，与宽带屏气PSIR-LGE相比，瘢痕与血液的对比度提高了200%，图像清晰度显著提高，熵降低。它还有效减少了ICD伪影并准确检测到瘢痕。在患者中，宽带MOCO自由呼吸BB-LGE序列每层面的重建时间为1.5±0.4（标准差）秒。17例（17/22；77%）有心肌瘢痕的患者通过宽带MOCO自由呼吸BB-LGE序列得到明确诊断，而宽带屏气PSIR-LGE序列诊断出11例（11/22；50%）（P<0.01）。
结论
自由呼吸宽带T2准备的黑血LGE成像结合运动校正重建，为评估ICD患者的心肌病变提供了一种有前景的诊断方法。
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