Elshibly Mohamed, Budgeon Charley, Shergill Simran, England Rachel, Parke Kelly, Moafi Aida, Xue Hui, Kellman Peter, McCann Gerry P, Arnold Jayanth R
Department of Cardiovascular Sciences, University of Leicester, and the National Institute for Health and Care Research (NIHR) Leicester Cardiovascular Biomedical Research Centre, Glenfield Hospital, Leicester LE3 9QP, UK.
Cardiovascular Epidemiology Research Centre, University of Western Australia, Perth, Australia.
Eur Heart J Imaging Methods Pract. 2025 Mar 5;2(4):qyaf026. doi: 10.1093/ehjimp/qyaf026. eCollection 2024 Oct.
Recent developments in the field of myocardial perfusion assessment with cardiovascular magnetic resonance (CMR) enable the automated inline quantification of myocardial blood flow (MBF). Previous studies have assessed its repeatability in healthy volunteers. This study assessed the repeatability of this technique in patients with suspected stable coronary artery disease (CAD).
Patients with suspected CAD were studied twice on separate days. CMR perfusion imaging was performed at rest and during adenosine stress using a dual-sequence T1-weighted saturation recovery gradient echo sequence. Inline automatic reconstruction and image post-processing were implemented within the Gadgetron software framework, calculating MBF using a blood tissue exchange model. Repeatability of global stress and rest MBF, and myocardial perfusion reserve (MPR) were evaluated using Bland-Altman plots and intraclass correlation coefficients. Fifty-four patients (mean age 67 ± 9 years, 78% male) were studied. The median interval between the two scans was 2 days (IQR 3). There was no significant interstudy difference in global stress MBF (1.46 ± 0.51 mL/min/g vs. 1.51 ± 0.59mLmin/g, = 0.44), global rest MBF (0.54 ± 0.14 mL/min/g vs. 0.56 ± 0.16 mL/min/g, = 0.48), or global MPR (2.72 ± 0.80 vs. 2.84 ± 1.13, = 0.76) between the two scans. Stress MBF, rest MBF, and MPR showed intraclass correlations of 0.60 (95% CI 0.39-0.75), 0.63 (95% CI 0.36-0.77), and 0.39 (95% CI 0.09-0.62), respectively.
In patients with suspected CAD, quantitative assessment of myocardial perfusion by fully automated inline myocardial mapping shows moderate repeatability for stress and rest MBF, but poorer repeatability with MPR.
心血管磁共振（CMR）在心肌灌注评估领域的最新进展使得能够对心肌血流量（MBF）进行自动在线定量分析。既往研究已评估了其在健康志愿者中的重复性。本研究评估了该技术在疑似稳定型冠状动脉疾病（CAD）患者中的重复性。
对疑似CAD患者在不同日期进行了两次研究。使用双序列T1加权饱和恢复梯度回波序列在静息状态和腺苷负荷状态下进行CMR灌注成像。在Gadgetron软件框架内进行在线自动重建和图像后处理，使用血液组织交换模型计算MBF。使用Bland-Altman图和组内相关系数评估整体负荷及静息MBF以及心肌灌注储备（MPR）的重复性。对54例患者（平均年龄67±9岁，78%为男性）进行了研究。两次扫描之间的中位间隔时间为2天（四分位间距3天）。两次扫描之间，整体负荷MBF（1.46±0.51 mL/min/g与1.51±0.59mL/min/g，P = 0.44）、整体静息MBF（0.54±0.14 mL/min/g与0.56±0.16 mL/min/g，P = 0.48）或整体MPR（2.72±0.80与2.84±1.13，P = 0.76）均无显著的研究间差异。负荷MBF、静息MBF和MPR的组内相关性分别为为0.60（95%CI 0.39 - 0.75）、为0.63（95%CI 0.36 - 0.77）和为0.39（95%CI 0.09 - 0.62）。
在疑似CAD患者中，通过全自动在线心肌成像对心肌灌注进行定量评估显示，负荷和静息MBF具有中等重复性，但MPR的重复性较差。
