Mousa Mohammed, Mahmoud Islam, Elkammash Tarek, Gad Azza, Noureldin Radwa
Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Department of Cardiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Magn Reson Imaging. 2025 Sep;121:110408. doi: 10.1016/j.mri.2025.110408. Epub 2025 May 6.
This study investigates the potential of segmental strain parameters derived from cine magnetic resonance imaging (MRI) using feature tracking (FT) to detect chronic ischemic scars in patients with ischemic heart disease, offering an alternative to late gadolinium enhancement (LGE) MRI, which has limitations such as long scan times and contraindications to gadolinium.
A total of 47 patients with chronic coronary syndrome and 20 healthy controls were enrolled, with CMR examinations performed on a 1.5 Tesla MRI system. Strain parameters were analyzed from 1072 myocardial segments. Myocardial segments were categorized into four groups: healthy controls, remote myocardium (no late gadolinium enhancement), scarred-viable (<50 % scar transmurality), and nonviable (>50 % scar transmurality).
Results showed significant differences in segmental peak circumferential strain (SPCS), peak radial strain (SPRS), and peak longitudinal strain (SPLS) between scarred viable and nonviable segments compared to remote and control segments, with all p-values <0.001. Specifically, SPCS had a superior ability to distinguish scarred myocardium from remote tissue, showing an area under the curve (AUC) of 0.77, with a sensitivity of 71.5 % and specificity of 70 %. For differentiating nonviable from viable myocardium, SPCS achieved an AUC of 0.80, with a sensitivity of 82.02 % and specificity of 70.21 %.
CMR-FT strain analysis is promising complementary tool, particularly in situations where contrast administration is contraindicated or when a rapid, non-contrast assessment of myocardial viability and potential scar burden is desired.
本研究探讨了利用特征跟踪（FT）从电影磁共振成像（MRI）中获取的节段应变参数检测缺血性心脏病患者慢性缺血性瘢痕的潜力，为钆延迟增强（LGE）MRI提供了一种替代方法，后者存在扫描时间长和钆剂禁忌等局限性。
共纳入47例慢性冠状动脉综合征患者和20例健康对照者，在1.5特斯拉MRI系统上进行心脏磁共振成像（CMR）检查。对1072个心肌节段的应变参数进行分析。心肌节段分为四组：健康对照、远隔心肌（无钆延迟增强）、瘢痕存活心肌（瘢痕透壁率<50%）和无存活心肌（瘢痕透壁率>50%）。
结果显示，与远隔心肌和对照节段相比，瘢痕存活心肌节段与无存活心肌节段之间的节段峰值圆周应变（SPCS）、峰值径向应变（SPRS）和峰值纵向应变（SPLS）存在显著差异，所有p值均<0.001。具体而言，SPCS区分瘢痕心肌与远隔组织的能力更强，曲线下面积（AUC）为0.77，敏感性为71.5%，特异性为70%。对于区分无存活心肌与存活心肌，SPCS的AUC为0.80，敏感性为82.02%，特异性为70.21%。
CMR-FT应变分析是一种很有前景的辅助工具，特别是在有钆剂使用禁忌的情况下，或者需要对心肌存活能力和潜在瘢痕负荷进行快速、无对比剂评估的情况下。
