Improved myocardial scar visualization using free-breathing motion-corrected wideband black-blood late gadolinium enhancement imaging in patients with implantable cardiac device.

IF 4.9 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Diagnostic and Interventional Imaging Pub Date : 2024-12-12 DOI:10.1016/j.diii.2024.12.001

Pauline Gut, Hubert Cochet, Panagiotis Antiochos, Guido Caluori, Baptiste Durand, Marion Constantin, Konstantinos Vlachos, Kalvin Narceau, Ambra Masi, Jürg Schwitter, Frederic Sacher, Pierre Jaïs, Matthias Stuber, Aurélien Bustin

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引用次数: 0

Abstract

Purpose: The purpose of this study was to introduce and evaluate a novel two-dimensional 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 1.5 T. 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, histopathological assessment 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.

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使用自由呼吸运动校正宽带黑血后期钆增强成像改善植入式心脏装置患者的心肌瘢痕可视化。

目的：本研究的目的是介绍和评估一种新的二维宽带黑血（BB） LGE序列，包括宽带反转恢复、宽带T2准备和非硬性运动校正（MOCO）重建，以改善心肌疤痕检测和解决与植入式心律转复除颤器（ICDs）相关的伪影。材料与方法：在1只缺血性瘢痕羊和22例心脏病患者（其中15例植入心脏）身上进行1.5 t的宽带MOCO自由呼吸BB-LGE序列测试，将宽带MOCO自由呼吸BB-LGE序列与常规和宽带屏气PSIR-LGE技术以及常规和宽带屏气BB-LGE技术进行比较。分析图像清晰度、熵、疤痕到血液、疤痕到心肌和血液到心肌的对比，并测量重建时间。两位专家读者评估了图像质量、ICD伪影严重程度和疤痕程度的诊断信心。最后，在动物实验中，对心脏进行组织病理学评估，以确认疤痕组织的存在和定位。结果：在动物中，宽带MOCO自由呼吸BB-LGE在0.6 s内重建，与宽带屏息PSIR-LGE相比，疤痕与血液的对比度提高了200%，图像清晰度显著提高，熵值降低。它还有效地减少了ICD伪影，准确地检测了疤痕。患者以1.5±0.4 s（标准差）/片重建宽带MOCO自由呼吸BB-LGE。17例(17/22；77%的患者有信心地诊断为宽带MOCO自由呼吸BB-LGE，而11 (11/22；50%)与宽带憋气PSIR-LGE （P < 0.01）。结论：自由呼吸宽频带t2制备的黑血LGE显像，结合运动校正重建，为评估icd患者心肌病变提供了一种有前景的诊断方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnostic and Interventional Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

8.50

自引率

29.10%

发文量

126

审稿时长

11 days

期刊介绍： Diagnostic and Interventional Imaging accepts publications originating from any part of the world based only on their scientific merit. The Journal focuses on illustrated articles with great iconographic topics and aims at aiding sharpening clinical decision-making skills as well as following high research topics. All articles are published in English. Diagnostic and Interventional Imaging publishes editorials, technical notes, letters, original and review articles on abdominal, breast, cancer, cardiac, emergency, forensic medicine, head and neck, musculoskeletal, gastrointestinal, genitourinary, interventional, obstetric, pediatric, thoracic and vascular imaging, neuroradiology, nuclear medicine, as well as contrast material, computer developments, health policies and practice, and medical physics relevant to imaging.