{"title":"心肌间质纤维化的自由呼吸非对比 T1ρ 弥散磁共振成像与细胞外体积分数的比较","authors":"Qinfang Miao, Sha Hua, Yiwen Gong, Zhenfeng Lyu, Pengfang Qian, Chun Liu, Wei Jin, Peng Hu, Haikun Qi","doi":"10.1016/j.jocmr.2024.101093","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Myocardial fibrosis is a common feature in various cardiac diseases. It causes adverse cardiac remodeling and is associated with poor clinical outcomes. Late gadolinium enhancement (LGE) and extracellular volume fraction (ECV) are the standard MRI techniques for detecting focal and diffuse myocardial fibrosis. However, these contrast-enhanced techniques require the administration of gadolinium contrast agents, which is not applicable to patients with gadolinium contraindications. To eliminate the need of contrast agents, we develop and apply an endogenous free-breathing T1ρ dispersion imaging technique (FB-MultiMap) for diagnosing diffuse myocardial fibrosis in a cohort with suspected cardiomyopathies.</p><p><strong>Methods: </strong>The proposed FB-MultiMap technique, enabling T2, T1ρ and their difference (myocardial fibrosis index, mFI) quantification in a single scan was developed in phantoms and 15 healthy subjects. In the clinical study, 55 patients with suspected cardiomyopathies were imaged using FB-MultiMap, conventional native T1 mapping, LGE, and ECV imaging. The accuracy of the endogenous parameters for predicting increased ECV was evaluated using receiver operating characteristic (ROC) curve analysis. In addition, the correlation of native T1, T1ρ, and mFI with ECV was respectively assessed using Pearson correlation coefficients.</p><p><strong>Results: </strong>FB-MultiMap showed a good agreement with conventional separate breath-hold mapping techniques in phantoms and healthy subjects. Considering all the patients, T1ρ was more accurate than mFI and native T1 for predicting increased ECV, with area under the curve (AUC) values of 0.91, 0.79 and 0.75, respectively, and showed stronger correlation with ECV (correlation coefficient r: 0.72 vs. 0.52 vs. 0.40). In the subset of 47 patients with normal T2 values, the diagnostic performance of mFI was significantly strengthened (AUC=0.90, r=0.83), outperforming T1ρ and native T1.</p><p><strong>Conclusion: </strong>The proposed free-breathing T1ρ dispersion imaging technique enabling simultaneous quantification of T2, T1ρ and mFI in a single scan has shown great potential for diagnosing diffuse myocardial fibrosis in patients with complex cardiomyopathies without contrast agents.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":null,"pages":null},"PeriodicalIF":4.2000,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Free-Breathing Non-Contrast T1ρ Dispersion MRI of Myocardial Interstitial Fibrosis in Comparison with Extracellular Volume Fraction.\",\"authors\":\"Qinfang Miao, Sha Hua, Yiwen Gong, Zhenfeng Lyu, Pengfang Qian, Chun Liu, Wei Jin, Peng Hu, Haikun Qi\",\"doi\":\"10.1016/j.jocmr.2024.101093\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Myocardial fibrosis is a common feature in various cardiac diseases. It causes adverse cardiac remodeling and is associated with poor clinical outcomes. Late gadolinium enhancement (LGE) and extracellular volume fraction (ECV) are the standard MRI techniques for detecting focal and diffuse myocardial fibrosis. However, these contrast-enhanced techniques require the administration of gadolinium contrast agents, which is not applicable to patients with gadolinium contraindications. To eliminate the need of contrast agents, we develop and apply an endogenous free-breathing T1ρ dispersion imaging technique (FB-MultiMap) for diagnosing diffuse myocardial fibrosis in a cohort with suspected cardiomyopathies.</p><p><strong>Methods: </strong>The proposed FB-MultiMap technique, enabling T2, T1ρ and their difference (myocardial fibrosis index, mFI) quantification in a single scan was developed in phantoms and 15 healthy subjects. In the clinical study, 55 patients with suspected cardiomyopathies were imaged using FB-MultiMap, conventional native T1 mapping, LGE, and ECV imaging. The accuracy of the endogenous parameters for predicting increased ECV was evaluated using receiver operating characteristic (ROC) curve analysis. In addition, the correlation of native T1, T1ρ, and mFI with ECV was respectively assessed using Pearson correlation coefficients.</p><p><strong>Results: </strong>FB-MultiMap showed a good agreement with conventional separate breath-hold mapping techniques in phantoms and healthy subjects. Considering all the patients, T1ρ was more accurate than mFI and native T1 for predicting increased ECV, with area under the curve (AUC) values of 0.91, 0.79 and 0.75, respectively, and showed stronger correlation with ECV (correlation coefficient r: 0.72 vs. 0.52 vs. 0.40). In the subset of 47 patients with normal T2 values, the diagnostic performance of mFI was significantly strengthened (AUC=0.90, r=0.83), outperforming T1ρ and native T1.</p><p><strong>Conclusion: </strong>The proposed free-breathing T1ρ dispersion imaging technique enabling simultaneous quantification of T2, T1ρ and mFI in a single scan has shown great potential for diagnosing diffuse myocardial fibrosis in patients with complex cardiomyopathies without contrast agents.</p>\",\"PeriodicalId\":15221,\"journal\":{\"name\":\"Journal of Cardiovascular Magnetic Resonance\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2024-09-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cardiovascular Magnetic Resonance\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jocmr.2024.101093\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cardiovascular Magnetic Resonance","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jocmr.2024.101093","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Free-Breathing Non-Contrast T1ρ Dispersion MRI of Myocardial Interstitial Fibrosis in Comparison with Extracellular Volume Fraction.
Background: Myocardial fibrosis is a common feature in various cardiac diseases. It causes adverse cardiac remodeling and is associated with poor clinical outcomes. Late gadolinium enhancement (LGE) and extracellular volume fraction (ECV) are the standard MRI techniques for detecting focal and diffuse myocardial fibrosis. However, these contrast-enhanced techniques require the administration of gadolinium contrast agents, which is not applicable to patients with gadolinium contraindications. To eliminate the need of contrast agents, we develop and apply an endogenous free-breathing T1ρ dispersion imaging technique (FB-MultiMap) for diagnosing diffuse myocardial fibrosis in a cohort with suspected cardiomyopathies.
Methods: The proposed FB-MultiMap technique, enabling T2, T1ρ and their difference (myocardial fibrosis index, mFI) quantification in a single scan was developed in phantoms and 15 healthy subjects. In the clinical study, 55 patients with suspected cardiomyopathies were imaged using FB-MultiMap, conventional native T1 mapping, LGE, and ECV imaging. The accuracy of the endogenous parameters for predicting increased ECV was evaluated using receiver operating characteristic (ROC) curve analysis. In addition, the correlation of native T1, T1ρ, and mFI with ECV was respectively assessed using Pearson correlation coefficients.
Results: FB-MultiMap showed a good agreement with conventional separate breath-hold mapping techniques in phantoms and healthy subjects. Considering all the patients, T1ρ was more accurate than mFI and native T1 for predicting increased ECV, with area under the curve (AUC) values of 0.91, 0.79 and 0.75, respectively, and showed stronger correlation with ECV (correlation coefficient r: 0.72 vs. 0.52 vs. 0.40). In the subset of 47 patients with normal T2 values, the diagnostic performance of mFI was significantly strengthened (AUC=0.90, r=0.83), outperforming T1ρ and native T1.
Conclusion: The proposed free-breathing T1ρ dispersion imaging technique enabling simultaneous quantification of T2, T1ρ and mFI in a single scan has shown great potential for diagnosing diffuse myocardial fibrosis in patients with complex cardiomyopathies without contrast agents.
期刊介绍:
Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to:
New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system.
New methods to enhance or accelerate image acquisition and data analysis.
Results of multicenter, or larger single-center studies that provide insight into the utility of CMR.
Basic biological perceptions derived by CMR methods.