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首页> 外文期刊>JACC. Cardiovascular imaging. >CMR imaging of edema in myocardial infarction using cine balanced steady-state free precession
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CMR imaging of edema in myocardial infarction using cine balanced steady-state free precession

机译：电影平衡稳态自由进动对心肌梗死水肿的CMR成像

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The aim of this study was to investigate the capabilities of balanced steady-state free precession (bSSFP) cardiac magnetic resonance imaging as a novel cine imaging approach for characterizing myocardial edema in animals and patients after reperfused myocardial infarction. Current cardiac magnetic resonance methods require 2 separate scans for assessment of myocardial edema and cardiac function. Mini-pigs (n = 13) with experimentally induced reperfused myocardial infarction and patients with reperfused ST-segment elevation myocardial infarction (n = 26) underwent cardiac magnetic resonance scans on days 2 to 4 post-reperfusion. Cine bSSFP, T2-weighted short TI inversion recovery (T2-STIR), and late gadolinium enhancement were performed at 1.5-T. Cine bSSFP and T2-STIR images were acquired with a body coil to mitigate surface coil bias. Signal, contrast, and the area of edema were compared. Additional patients (n = 10) were analyzed for the effect of microvascular obstruction on bSSFP. A receiver-operator characteristic analysis was performed to assess the accuracy of edema detection. An area of hyperintense bSSFP signal consistent with edema was observed in the infarction zone (contrast-to-noise ratio: 37 ± 13) in all animals and correlated well with the area of late gadolinium enhancement (R = 0.83, p < 0.01). In all patients, T2-STIR and bSSFP images showed regional hyperintensity in the infarction zone. Normalized contrast-to-noise ratios were not different between T2-STIR and bSSFP. On a slice basis, the volumes of hyperintensity on T2-STIR and bSSFP images correlated well (R = 0.86, p < 0.001), and their means were not different. When compared with T2-STIR, bSSFP was positive for edema in 25 of 26 patients (96% sensitivity) and was negative in all controls (100% specificity). All patients with microvascular obstruction showed a significant reduction of signal in the subendocardial infarction zone compared with infarcted epicardial tissue without microvascular obstruction (p < 0.05). Myocardial edema from ST-segment elevation myocardial infarction can be detected using cine bSSFP imaging with image contrast similar to T2-STIR. This new imaging approach allows evaluation of cardiac function and edema simultaneously, thereby reducing patient scan time and increasing efficiency. Further work is necessary to optimize edema contrast in bSSFP images.
机译：这项研究的目的是研究平衡稳态自由进动（bSSFP）心脏磁共振成像作为一种新颖的电影成像方法来表征动物和患者再灌注心肌梗死后心肌水肿的能力。当前的心脏磁共振方法需要进行2次单独扫描以评估心肌水肿和心功能。实验诱导的再灌注心肌梗死的小型猪（n = 13），再灌注ST段抬高型心肌梗死（n = 26）的患者在再灌注后2至4天接受心脏磁共振扫描。在1.5-T下进行电影bSSFP，T2加权短TI反转恢复（T2-STIR）和后期late增强。使用体线圈来获取电影bSSFP和T2-STIR图像，以减轻表面线圈的偏斜。比较信号，对比度和水肿面积。分析了其他患者（n = 10）的微血管阻塞对bSSFP的影响。进行接收者-操作者特征分析以评估水肿检测的准确性。在所有动物的梗死区均观察到与水肿相符的高强度bSSFP信号区域（对比噪声比：37±13），并与g后期增强区域相关（R = 0.83，p <0.01）。在所有患者中，T2-STIR和bSSFP图像均显示梗塞区域的局部高信号。 T2-STIR和bSSFP之间的归一化对比度噪声比没有差异。在切片的基础上，T2-STIR和bSSFP图像上的高信号强度相关性很好（R = 0.86，p <0.001），并且它们的均值没有差异。与T2-STIR相比，bSSFP在26名患者中的25名患者中水肿呈阳性（敏感性为96％），在所有对照中均为阴性（特异性为100％）。与无微血管阻塞的梗死性心外膜组织相比，所有具有微血管阻塞的患者在心内膜下梗死区域的信号均显着降低（p <0.05）。可以使用电影bSSFP成像检测ST段抬高型心肌梗死引起的心肌水肿，图像对比度类似于T2-STIR。这种新的成像方法可以同时评估心脏功能和水肿，从而减少了患者的扫描时间并提高了效率。需要进一步的工作来优化bSSFP图像中的水肿对比度。

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