Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Association of Epicardial Adipose Tissue and Biventricular Strain in Heart Failure with Preserved and Reduced Ejection Fraction.","authors":"Yu-Jiao Song, Ting Ning, Ming-Tian Chen, Xiao-Ying Zhao, Wan-Qiu Zhang, Lu-Jing Wang, Xin-Xiang Zhao","doi":"10.1016/j.jocmr.2025.101935","DOIUrl":"10.1016/j.jocmr.2025.101935","url":null,"abstract":"<p><strong>Background and purpose: </strong>Epicardial adipose tissue (EAT) plays a crucial role in the progression of heart failure (HF). This study employs cardiac magnetic resonance (CMR) imaging to investigate potential differences in EAT between patients with heart failure with reduced ejection fraction (HFrEF) and those with heart failure with preserved ejection fraction (HFpEF), as well as the correlation between EAT and biventricular function (myocardial strain).</p><p><strong>Methods: </strong>We collected data from patients diagnosed with HF at the Second Affiliated Hospital of Kunming Medical University between January 2021 and December 2023. All patients underwent CMR imaging and were categorized into two groups based on left ventricular ejection fraction (LVEF): the HFrEF group and the HFpEF group. Patients without heart failure served as the control group. We gathered clinical baseline data and utilized the CVI-42 post-processing software to obtain parameters related to cardiac structure and function, including LVEF, global radial strain (GRS), global longitudinal strain (GLS), EAT, pericardial adipose tissue (PeAT), paracardial adipose tissue (PaAT), and wall stress. We compared the differences in parameters among the three groups and conducted pairwise comparisons. Additionally, we performed correlation analyses of EAT and PeAT with GLS and body mass index (BMI) within the HFrEF and HFpEF cohorts.</p><p><strong>Results: </strong>A total of 104 patients with HFrEF, 226 patients with HFpEF, and 172 patients without heart failure were ultimately included in the study. Significant statistical differences were observed among the three groups regarding age, smoking status, diabetes, brain natriuretic peptide (BNP) levels, BMI, EAT, PeAT, PaAT, wall stress, GLS and GRS of both ventricles (P < 0.05). The EAT volume in HFrEF patients (32 ± 14ml) was lower than that in HFpEF patients (51 ± 21ml) and the control group (33 ± 19ml). Additionally, PeAT and PaAT levels were higher in HFpEF patients compared to those in HFrEF and the control group. Correlation analysis revealed that in HFrEF patients, EAT accumulation was associated with better left ventricular (LV) function (LVGLS, r = 0.85, p < 0.01) and right ventricular (RV) function (RVGLS, r = 0.73, p < 0.01). Conversely, in HFpEF patients, EAT accumulation correlated with poorer LV (LVGLS, r = -0.67, p < 0.01) and RV (RVGLS, r = 0.55, p < 0.01) function.</p><p><strong>Conclusion: </strong>EAT was greater in patients with HFpEF compared to HFrEF. In the HFpEF group, increased EAT was correlated with worsening biventricular function, while the opposite trend was observed in the HFrEF group.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101935"},"PeriodicalIF":6.1,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CMR versus CCTA with fractional flow reserve for diagnosing obstructive coronary artery disease in higher risk patients: rationale and design of CONCORD - a prospective, single-centre diagnostic accuracy study.","authors":"Simran Shergill, Mohamed Elshibly, Kelly S Parke, Rachel England, Joanne V Wormleighton, Indrajeet Das, Gaurav S Gulsin, Sandeep S Hothi, Robert Heggie, Olivia Wu, Peter Kellman, Alasdair McIntosh, Alex McConnachie, Andrew Ladwiniec, Gerry P McCann, J Ranjit Arnold","doi":"10.1016/j.jocmr.2025.101939","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101939","url":null,"abstract":"<p><strong>Background: </strong>In patients with suspected coronary artery disease (CAD), the optimal diagnostic algorithm remains uncertain. Non-invasive imaging plays a central role as a \"gatekeeper\" to invasive coronary angiography, with both cardiovascular magnetic resonance (CMR) and coronary computed tomography angiography (CCTA) with fractional flow reserve (FFR_CT) proving effective in reducing unnecessary invasive procedures. However, direct comparisons between the two modalities are limited.</p><p><strong>Trial design: </strong>CONCORD is a prospective, single-centre study comparing the diagnostic accuracy of CMR and CCTA/FFR_CT to detect obstructive CAD in 300 patients with suspected angina referred for clinically indicated invasive coronary angiography. The primary outcome is the diagnostic accuracy of each imaging protocol against the reference standard of invasive fractional flow reserve. Key secondary outcomes include whether quantitative CMR is more accurate than qualitative CMR and/or CCTA/FFR_CT, and whether hybrid imaging models may outperform single modality strategies (NCT04761991).</p><p><strong>Summary: </strong>CONCORD will comprehensively evaluate two frontline non-invasive functional imaging modalities in patients with suspected angina and determine the comparative accuracy of CCTA/FFR_CT and CMR in patients with a moderate-high risk of CAD. Evaluation of these strategies has the potential to inform both the quality and cost-effectiveness of imaging services.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101939"},"PeriodicalIF":6.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High variability in reporting of right ventricle contouring technique and body surface area methodology in cardiac magnetic resonance studies of patients with repaired Tetralogy of Fallot: A systematic review.","authors":"Abbey J Grbac, Phillip S Naimo, Jeremy J Russo, Samuel J Fogarty, William M Wilson, Dominica Zentner, Katherine M English, Leeanne E Grigg, Andrew J Taylor, Elaine H Lui, Subodh B Joshi, Melissa G Y Lee","doi":"10.1016/j.jocmr.2025.101942","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101942","url":null,"abstract":"<p><strong>Background: </strong>Timing of pulmonary valve intervention (PVI) for pulmonary regurgitation in patients with repaired Tetralogy of Fallot (TOF) is guided by right ventricle (RV) volumetric/function assessment on cardiac magnetic resonance (CMR) indexed to actual body surface area (BSA). However, different RV contouring techniques and BSA formulae exist with significant variability in reported measurements. We aimed to review the protocols reported in CMR studies of PVI in TOF.</p><p><strong>Methods: </strong>A search of electronic databases (Embase and MEDLINE) was performed to identify studies published between 28/2/10-28/2/25 which assessed adults with repaired TOF before and after PVI using CMR. RV contouring methods and BSA formulae were reviewed.</p><p><strong>Results: </strong>After screening 610 references, a total of 27 studies met criteria and were included. All studies were of only level III or level IV (lowest) levels of evidence. Most studies (81%, 22/27) did not specify the RV contouring technique used and none defined the RV basal slice. Of the 5 studies describing the RV contouring technique, 4 excluded trabeculations/papillary muscles from the RV volume and 1 included these structures. No studies reported the formula used to calculate actual BSA.</p><p><strong>Conclusion: </strong>RV contouring technique and BSA methodology utilised in CMR studies of PVI in TOF is poorly reported. Given the importance of severity thresholds for RV volumes in triggering intervention in clinical practice, clear reporting and standardisation of RV contouring and BSA methodology should be mandatory. Further research into the optimal RV thresholds for PVI based on clear contouring methods is required.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101942"},"PeriodicalIF":6.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitral Annular Disjunction in Marfan Syndrome: A Multicenter Cardiovascular Magnetic Resonance Study.","authors":"Kenan Kaya, Jonathan Kottlors, Thorsten W Gietzen, Leon Bischoff, Jan M Brendel, Reza Dehdab, Moritz C Halfmann, Lukas Müller, Philipp V Stein, Lukas Goertz, Jan Paul Janßen, Roman Johannes Gertz, Robert Terzis, Vanessa Schmidt, Kilian Weiss, Christopher Hohmann, David Maintz, Tilman Emrich, Patrick Krumm, Julian A Luetkens, Carsten H Gietzen, Lenhard Pennig","doi":"10.1016/j.jocmr.2025.101938","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101938","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Data on the prevalence of mitral annular disjunction (MAD) in Marfan syndrome (MFS) based on cardiovascular magnetic resonance (CMR) is sparse. The purpose of this study was to assess prevalence, extent, and distribution of MAD in MFS using CMR and to examine its association with left heart parameters, aortic dimensions, and cardiovascular events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective multicenter study included CMR studies of patients treated for MFS at four tertiary care medical centers with a (likely) pathogenic fibrillin-1 gene variant. Two radiologists (five and eight years of experience in CMR) evaluated datasets for MAD (at four points around the annulus, including measurement of extent) and mitral valve prolapse (MVP). Further assessment comprised volumetric and functional analysis of the left ventricle (LV), left atrial size, and aortic root diameters. Cardiovascular events included aortic (aortic surgery or aortic dissection), arrhythmic (sustained ventricular tachycardia or sudden cardiac death), and mitral events (mitral valve surgery, MVS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 91 patients (28.9±14.0 years, 47.3% female), 81.3% had MAD (extent: 6.1±2.6mm). MAD was mostly found at the inferior insertion (72.5% of patients) and usually affected all sites (39.6% of patients). Left heart parameters and aortic dimensions did not differ between MAD and no MAD groups (P&gt;0.05). MAD extent and localizations showed significant correlations with LV dilatation (e.g., inferior MAD: r=0.62 for end-diastolic volume index), decreased LV ejection fraction (e.g., anterolateral MAD: r=-0.46), and MVP (e.g., MAD distance: r=0.83), which was found in 44.6% of patients with MAD while only affecting 11.8% without MAD (P=0.017). Based on receiver operating characteristic analysis for the prediction of MVP prevalence, a threshold of 7.1mm MAD extent was identified as the optimal cut-off value (sensitivity: 77.1%, specificity: 89.3%). Additionally, subgroup analysis applying different thresholds of MAD extent revealed a significantly larger displacement of MVP and LV volumes as well as higher aortic root z scores for a threshold of ≥ 8mm. After a mean follow-up of 4.0±3.0 years, cardiovascular events [aortic: n=13 (14.3%), arrhythmic: n=2 (2.2%), and mitral: n=2 (2.2%) of patients] did not differ significantly (all P&gt;0.05) between no MAD and MAD groups regardless of applied thresholds although MVS was observed exclusively in patients with MAD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The high prevalence, large extent, and predominantly pan-annular distribution of MAD suggest a systemic annular pathology in MFS. Overall presence of MAD was not associated with changes to left heart parameters, aortic dimensions, and cardiovascular events. However, MAD, taking into account its extent and affected insertion sites, could serve as a potential marker of disease progression given the shown association of localizations and distanc","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101938"},"PeriodicalIF":6.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SCMR Expert Consensus Statement on Quantitative Myocardial Perfusion Cardiovascular Magnetic Resonance Imaging.","authors":"Amedeo Chiribiri, Andrew E Arai, Edward DiBella, Li-Yueh Hsu, Masaki Ishida, Michael Jerosch-Herold, Sebastian Kozerke, Xenios Milidonis, Reza Nezafat, Sven Plein, Cian M Scannell, Michael Salerno","doi":"10.1016/j.jocmr.2025.101940","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101940","url":null,"abstract":"<p><p>Myocardial perfusion imaging plays a central role in the management of patients with known or suspected coronary artery disease (CAD) and increasingly in patients with suspected ischemia with normal coronary arteries (INOCA) as well as anomalous origins of the coronary arteries and Kawasaki disease. Stress perfusion cardiovascular magnetic resonance (CMR) is recognized by international guidelines, with several Class 1 indications for the detection of abnormal myocardial blood flow in these clinical scenarios and offers excellent diagnostic accuracy and independent prognostic value. While visual interpretation of the perfusion data is the prevailing analysis method in clinical practice, quantitative perfusion CMR is at least as accurate for the detection of significant obstructive CAD and provides a more accurate estimation of the total ischemic burden in patients with CAD. Moreover, quantitative myocardial perfusion analysis provides unique insights into the pathophysiology of myocardial ischemia, including microvascular disease in INOCA. Quantitative perfusion CMR can be fully automated, is user-independent, and may facilitate more widespread use of the modality. The aim of this Society for Cardiovascular Magnetic Resonance (SCMR) expert consensus document is to provide recommendations for the acquisition and analysis of quantitative myocardial perfusion CMR to facilitate standardization of methodology. This paper also discusses research and development goals to address current limitations, to ensure data reliability and validity, to create the basis for future multi-vendor and multi-center research, and to broaden the clinical use of quantitative perfusion CMR.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101940"},"PeriodicalIF":6.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased extracellular volume after aortic valve replacement: a footprint of reverse ventricular remodeling that does not affect conduction velocity.","authors":"Vladimír Sobota, Christoph M Augustin, Gernot Plank, Edward J Vigmond, Sarah Nordmeyer, Jason D Bayer","doi":"10.1016/j.jocmr.2025.101936","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101936","url":null,"abstract":"<p><strong>Background: </strong>Extracellular volume (ECV) determined by cardiovascular magnetic resonance (CMR) is considered a marker of diffuse myocardial fibrosis and a predictor of mortality. Using personalized computational models, we investigated the relationship between ECV, conduction velocity (CV), and cell radius in aortic stenosis (AS) patients.</p><p><strong>Methods: </strong>CMR was performed on 12 AS patients (6 males, 6 females) before and 3 months after surgical aortic valve replacement (AVR). All patients had a QRS≤110 ms, and no scar on late gadolinium enhanced (LGE) CMR. Computational biventricular models were developed from each CMR dataset. Using patient-specific ECV and the relative change in cell radius between the time points as inputs, tissue conductivity was adjusted in each model to match the patient's QRS duration. A physiological pattern of ventricular depolarization was mimicked by simultaneously pacing each model from 5 activation sites. CV was measured during a simulation of apical pacing, using two points positioned at the right ventricular septum of the model.</p><p><strong>Results: </strong>Left ventricular mass decreased after AVR (62 [58-79] vs. 51 [41-60] g/m², p=0.0005) while ECV increased (24.2 [20.6-24.8] vs. 28.0 [25.1-29.5] %, p=0.0008). No changes in the patient's QRS duration (89.0 [80.5-99.0] vs. 88 [78.5-99.5] ms, p=0.2148) were observed. No changes in the CV obtained from the models (64.3 [61.9-72.8] vs. 66.0 [60.0-74.5] cm/s, p=0.5186) were found between the time points, suggesting there was no substantial increase in diffuse fibrosis. ECV was negatively correlated with cell radius (r=-0.5267, p=0.0082), but not correlated with CV obtained from the models (r=-0.2036, p=0.3399).</p><p><strong>Conclusion: </strong>Increased ECV 3 months after AVR in patients with no LGE scar and with normal ventricular conduction appears to be a footprint of reverse ventricular remodeling that does not necessarily translate into changes in myocardial CV.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101936"},"PeriodicalIF":6.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Atrial Volumetric and Functional Remodeling Post-Pulmonary Vein Isolation: Insights from Cardiac Magnetic Resonance Imaging.","authors":"Nikki van Pouderoijen, Luuk H G A Hopman, Leontine E Wentrup, Joris R de Groot, Michiel J B Kemme, Cornelis P Allaart, Marco J W Götte","doi":"10.1016/j.jocmr.2025.101937","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101937","url":null,"abstract":"<p><strong>Aim: </strong>To assess left atrial (LA) volumetric and functional remodeling parameters using cardiac magnetic resonance (CMR) imaging early and late after pulmonary vein isolation (PVI) in atrial fibrillation (AF) patients.</p><p><strong>Methods and results: </strong>This study involved 61 AF patients undergoing radiofrequency (RF) PVI. CMR scans were performed pre-PVI, within 72hours and 3 months post-PVI. LA volumes and strain were assessed using two- and four-chamber cine images. Early AF recurrence was monitored during 3 months follow-up.LAVImin significantly increased early post-PVI (22.5±8.7mL/m² to 25.8±9.9mL/m²,p<0.01). At 3 months, both LAVImin and LAVImax significantly reduced compared to early post-PVI (25.4±8.87mL/m² to 19.4±7.7mL/m²,p<0.001;48.2±12.7mL/m² to 38.7±10.6mL/m²,p<0.001, respectively), as well as compared to baseline (22.5±8.7mL/m² to 20.1±8.5mL/m²,p=0.04;45.6±11.8mL/m² to 39.3±11.2mL/m²,p<0.001, respectively). Early post-PVI, LA emptying fraction (LA EF), LA reservoir, and contractile strain significantly reduced compared to baseline (from 51.6±10.8% to 47.1±8.9%,p<0.01;18.3±4.4% to 15.4±2.9%,p<0.001;8.3±3.1% to 5.4±1.8%,p<0.001, respectively). At 3 months, LA EF, LA reservoir, and contractile strain significantly increased as compared to early post-PVI (from 47.1±8.9% to 50.5±8.6%,p<0.01;15.4±2.9% to 16.8±3.1%,p<0.01;5.4±1.8% to 6.9±2.3%,p<0.001, respectively). However, LA reservoir and contractile strain remained significantly lower compared to baseline (18.3±4.4% to 16.8±3.1%,p=0.02;8.3±3.1% to 6.9±2.3%,p<0.01, respectively). In patients with early AF recurrence (27.9%), LA volume reduction and partial functional recovery was not observed during 3 months post-PVI.</p><p><strong>Conclusion: </strong>LA volumes significantly reduced 3 months post-PVI. While LA function initially declined, it showed partial recovery at 3 months. However, LA reservoir and contractile strain remained reduced compared to pre-PVI. LA reverse remodeling and partial LA functional recovery only occurred in patients without early AF recurrence.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101937"},"PeriodicalIF":6.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artifacts in cardiac T1 and T2 mapping techniques - Influence on reliable quantification.","authors":"Maximilian Fenski, Jan Gröschel, Peter Gatehouse, Christoph Kolbitsch, Jeanette Schulz-Menger","doi":"10.1016/j.jocmr.2025.101934","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101934","url":null,"abstract":"<p><p>Cardiac T1 and T2 mapping techniques are well-established methods for obtaining quantitative pixelwise representations of myocardial tissue properties. Mapping images are commonly evaluated quantitatively, and their resulting values play a crucial role in diagnosis and therapeutic decision making in various cardiac pathologies. Despite the validated effectiveness of these techniques, both methodological and patient-specific confounders must be considered when applying them in clinical and research settings. Artifacts - erroneous features within the MR image - can be misinterpreted as true anatomical structures or pathologies, potentially confounding quantitative analyses, conducted by both human readers and AI algorithms. Artifacts can arise from sources such as patient motion, metal objects, hardware constraints, patient-specific scanner adjustments (e.g. flip-angle calibration) and processing errors, particularly within the complex environment of cardiac imaging. While artifact sources in other CMR sequences are well documented, cardiac parametric mapping presents unique challenges due to its distinct image generation and quantitative assessment. This article provides an overview of artifacts encountered in cardiac T1 and T2 mapping, along with a concise explanation of their origins, aiming to raise awareness of their potential impact on clinical decision making. Future developments, including sequences designed to mitigate mapping artifacts, are also briefly discussed. A strong interaction between scientists and clinicians is needed to overcome these challenges and maintain the reliability of quantification results.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101934"},"PeriodicalIF":6.1,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Splenic Switch-Off in 3D Adenosine Stress CMR Perfusion for Differentiating False-Negative from True-Negative Studies Identified by FFR.","authors":"Mihály Károlyi, Maximilian Fuetterer, Márton Kolossváry, Verena C Wilzeck, Sven Plein, Andrea Biondo, Alexander Gotschy, Michael Frick, Rolf Gebker, Hatem Alkadhi, Ingo Paetsch, Cosima Jahnke, Sebastian Kozerke, Robert Manka","doi":"10.1016/j.jocmr.2025.101933","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101933","url":null,"abstract":"<p><strong>Background: </strong>False-negative cardiac magnetic resonance (CMR) perfusion results may arise from inadequate stress responses, even when patients exhibit an adequate clinical or heart-rate response to adenosine. This study aimed to explore the ability of qualitative and quantitative splenic switch-off markers to differentiate false-negative from true-negative adenosine stress-perfusion CMR findings, in a cohort where fractional flow reserve (FFR) was used to adjudicate lesion significance.</p><p><strong>Methods: </strong>Patients with known or suspected coronary artery disease (CAD) from five centers underwent 3D adenosine stress perfusion CMR and coronary angiography with FFR. Splenic switch-off was assessed qualitatively using both standard stress-to-rest (SSO) and a stress-only (SSO_stress) approach. In addition, quantitative signal intensity (SI) ratios were assessed, including the splenic stress-to-rest SI-ratio (SI_stress/rest) and the spleen-to-myocardium SI ratio at stress (SI_{spleen/myocarcium}). The diagnostic accuracy of these measures was evaluated using cross-validated area under the curve (cvAUC) analysis.</p><p><strong>Results: </strong>Among 179 patients (mean age 63 ± 10 years; 130 male), SSO prevalence was 73% and was significantly more frequent in true-negative than false-negative CMR cases (80.6% vs. 36.8%, p<0.001). SSO_stress showed moderate agreement (κ = 0.60) and robust diagnostic performance (AUC 0.80), as compared to SSO. Splenic SI_stress/rest and SI_{spleen/myocarcium} at stress demonstrated high predictive accuracy for visual SSO, with cvAUCs of 0.94 (95% CI: 0.90-0.96) and 0.90 (95% CI: 0.86-0.95), respectively. The positive likelihood ratio of SSO for true-negative CMR was 1.70, while the negative likelihood ratio was 0.24, indicating false-negative CMR when SSO was absent. Qualitative and quantitative splenic-switch off metrics classified 77-80% of negative CMR cases correctly as true- or false-negatives, with sensitivities ranging from 81.4% to 91.2%. Clinically applicable cut-offs for differentiating true- and false-negative studies with splenic SI_stress/rest and SI_{spleen/myocarcium} at stress were identified as ≤0.32 and ≤0.38, respectively.</p><p><strong>Conclusion: </strong>In a multicenter cohort using FFR-adjudicated reference for lesion severity, qualitative SSO and quantitative signal intensity metrics were associated with myocardial stress adequacy and these markers may improve the interpretation of negative stress-perfusion CMR studies.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101933"},"PeriodicalIF":4.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a deep learning algorithm for detecting significant coronary artery stenosis in whole-heart coronary magnetic resonance angiography.","authors":"Masafumi Takafuji, Masaki Ishida, Takuma Shiomi, Ryohei Nakayama, Miyuko Fujita, Shintaro Yamaguchi, Yuzo Washiyama, Motonori Nagata, Yasutaka Ichikawa, R T Inoue Katsuhiro, Satoshi Nakamura, Hajime Sakuma","doi":"10.1016/j.jocmr.2025.101932","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101932","url":null,"abstract":"<p><strong>Background: </strong>Whole-heart coronary magnetic resonance angiography (CMRA) enables noninvasive and accurate detection of coronary artery stenosis. Nevertheless, the visual interpretation of CMRA is constrained by the observer's experience, necessitating substantial training. The purposes of this study were to develop a deep learning (DL) algorithm using a deep convolutional neural network to accurately detect significant coronary artery stenosis in CMRA and to investigate the effectiveness of this DL algorithm as a tool for assisting in accurate detection of coronary artery stenosis.</p><p><strong>Methods: </strong>Nine hundred and fifty-one coronary segments from 75 patients who underwent both CMRA and invasive coronary angiography (ICA) were studied. Significant stenosis was defined as a reduction in luminal diameter of >50% on quantitative ICA. A DL algorithm was proposed to classify CMRA segments into those with and without significant stenosis. A 4-fold cross-validation method was used to train and test the DL algorithm. An observer study was then conducted using 40 segments with stenosis and 40 segments without stenosis. Three radiology experts and 3 radiology trainees independently rated the likelihood of the presence of stenosis in each coronary segment with a continuous scale from 0 to 1, first without the support of the DL algorithm, then using the DL algorithm.</p><p><strong>Results: </strong>Significant stenosis was observed in 84 (8.8%) of the 951 coronary segments. Using the DL algorithm trained by the 4-fold cross-validation method, the area under the receiver operating characteristic curve (AUC) for the detection of segments with significant coronary artery stenosis was 0.890, with 83.3% sensitivity, 83.6% specificity and 83.6% accuracy. In the observer study, the average AUC of trainees was significantly improved using the DL algorithm (0.898) compared to that without the algorithm (0.821, p<0.001). The average AUC of experts tended to be higher with the DL algorithm (0.897), but not significantly different from that without the algorithm (0.879, p=0.082).</p><p><strong>Conclusion: </strong>We developed a DL algorithm offering high diagnostic accuracy for detecting significant coronary artery stenosis on CMRA. Our proposed DL algorithm appears to be an effective tool for assisting inexperienced observers to accurately detect coronary artery stenosis in whole-heart CMRA.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101932"},"PeriodicalIF":4.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}