一键式联合配准T2映射与双黑血和亮血延迟钆增强磁共振成像用于急性ST段抬高型心肌梗死心肌损伤的综合评估
One-click co-registered T2 mapping and dual black- and bright-blood late gadolinium enhancement MRI for comprehensive assessment of myocardial injury after acute STEMI.
作者信息
Bustin Aurelien, de Villedon de Naide Victor, Gerbaud Edouard, Génisson Thaïs, Narceau Kalvin, Richard Théo, Vlachos Konstantinos, Caluori Guido, Bazin Claire, Sridi Soumaya, Benlala Ilyes, Dournes Gael, Sermesant Maxime, Montaudon Michel, Jaïs Pierre, Stuber Matthias, Cochet Hubert
机构信息
IHU LIRYC, Heart Rhythm Disease Institute, Hôpital Xavier Arnozan, Université de Bordeaux-INSERM U1045, Avenue du Haut Lévêque, Pessac 33604, France.
Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, Pessac 33604, France.
出版信息
Eur Heart J Imaging Methods Pract. 2025 Aug 11;3(2):qyaf103. doi: 10.1093/ehjimp/qyaf103. eCollection 2025 Jul.
AIMS
In acute ST-segment elevation myocardial infarction, ischaemia and reperfusion lead to a cascade of myocardial injury that can be characterized by cardiac magnetic resonance (CMR) imaging, including coagulation necrosis, oedema, papillary muscle damage, microvascular obstruction, and intramyocardial haemorrhage. Conventional CMR protocols require multiple sequences to be performed and complicated analysis. This study evaluates SPOT-MAPPING, a sequence that acquires co-registered T2 maps and dual bright- and black-blood late gadolinium enhancement (LGE) images in a single scan.
METHODS AND RESULTS
SPOT-MAPPING employs a single-shot, ECG-triggered 2D sequence alternating between bright- and black-blood LGE imaging with varying T2 weightings. We prospectively enrolled 20 STEMI patients undergoing CMR at 1.5 T within 4-7 days post-emergent coronary intervention. SPOT-MAPPING's segmentation times and reproducibility of myocardial injury markers (oedema, scar size, transmurality, papillary muscle damage) were assessed against conventional T2 mapping and phase-sensitive inversion recovery (PSIR). SPOT-MAPPING halved left ventricular wall segmentation time (∼3 min) while maintaining high reproducibility for oedema, scar size, and transmurality (ICC > 0.8). It improved papillary muscle damage detection over PSIR (8 vs. 3 patients) and showed comparable T2 values with conventional T2 mapping (remote: 45.0 ± 3.6 ms vs. 45.9 ± 3.7 ms, = 0.746; oedema: 67.6 ± 10.3 ms vs. 71.8 ± 8.6 ms, = 0.373). Agreement with PSIR for scar quantification was strong (mean bias: volume +1.5 mL, size +2.9%, transmurality +2.8%). SPOT-MAPPING demonstrated higher inter- and intraobserver reproducibility for scar size as a percentage of oedema volume compared with PSIR combined with conventional T2 mapping (ICC = 0.98 vs. 0.89 and 0.93 vs. 0.85).
CONCLUSION
SPOT-MAPPING offers a time-efficient and reproducible CMR method for myocardial injury assessment post-STEMI.
目的
在急性ST段抬高型心肌梗死中，缺血和再灌注会引发一系列心肌损伤，这些损伤可通过心脏磁共振（CMR）成像来表征，包括凝固性坏死、水肿、乳头肌损伤、微血管阻塞和心肌内出血。传统的CMR协议需要执行多个序列并进行复杂的分析。本研究评估了SPOT-MAPPING，这是一种在单次扫描中获取共配准的T2图以及双亮血和黑血延迟钆增强（LGE）图像的序列。
方法和结果
SPOT-MAPPING采用单次激发、心电图触发的二维序列，在具有不同T2加权的亮血和黑血LGE成像之间交替。我们前瞻性纳入了20例在急诊冠状动脉介入治疗后4 - 7天内接受1.5 T CMR检查的ST段抬高型心肌梗死（STEMI）患者。将SPOT-MAPPING对心肌损伤标志物（水肿、瘢痕大小、透壁性、乳头肌损伤）的分割时间和可重复性与传统T2 mapping和相位敏感反转恢复（PSIR）进行了比较。SPOT-MAPPING将左心室壁分割时间减半（约3分钟），同时在水肿、瘢痕大小和透壁性方面保持高可重复性（组内相关系数>0.8）。与PSIR相比，它改善了乳头肌损伤的检测（8例对3例患者），并且与传统T2 mapping显示出相当的T2值（远隔心肌：45.0±3.6毫秒对45.9±3.7毫秒，P = 0.746；水肿：67.6±10.3毫秒对71.8±8.6毫秒，P = 0.373）。与PSIR在瘢痕定量方面的一致性很强（平均偏差：体积+1.5毫升，大小+2.9%，透壁性+2.8%）。与PSIR联合传统T2 mapping相比，SPOT-MAPPING在瘢痕大小占水肿体积百分比方面显示出更高的观察者间和观察者内可重复性（组内相关系数=0.98对0.89以及0.93对0.85）。
结论
SPOT-MAPPING为STEMI后心肌损伤评估提供了一种省时且可重复的CMR方法。
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