用自由呼吸三维各向同性全心T1和T2联合绘图序列评估心肌炎

IF 4.2 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Alina Hua, Carlos Velasco, Camila Munoz, Giorgia Milotta, Anastasia Fotaki, Filippo Bosio, Inka Granlund, Agata Sularz, Amedeo Chiribiri, Karl P Kunze, Rene Botnar, Claudia Prieto, Tevfik F Ismail
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引用次数: 0

摘要

背景:通过 CMR 诊断心肌炎需要使用 T2 和 T1 加权成像,最好能结合参数映射。目前的二维绘图序列是顺序采集的,需要多次屏气,导致扫描时间延长和图像分辨率各向异性。我们开发了一种各向同性的自由呼吸三维全心序列,可同时进行 T1 和 T2 映射,并在疑似急性心肌炎患者中进行了验证:18名健康志愿者和28名疑似心肌炎患者在一台1.5T扫描仪上接受了覆盖全心的传统二维T1和T2成像以及三维联合T1/T2成像。对采集时间、图像质量和诊断性能进行了比较。采用 4 点李克特量表进行定性分析。使用Bland-Altman图评估二维和三维序列的定量一致性:在自由呼吸的情况下,三维 T1/T2 序列的采集时间为 8 分 26 秒,而在屏气的情况下,二维 T1 和 T2 序列的采集时间为 11 分 44 秒(P=0.0001)。所有二维图像均具有诊断意义。在三维图像中,89% 的 T1 和 96% 的 T2 图像具有诊断意义,三维和二维 T1 和 T2 图像的诊断比例无显著差异(p=0.2482)(p=1.0000)。T1 存在系统性偏差,基底-心尖节段的偏差分别为 102ms、115ms 和 152ms,T1 值越高偏差越大。三维和二维技术的 T2 值具有良好的一致性(基底-心尖节段的偏差分别为 1.8 毫秒、3.9 毫秒和 3.6 毫秒)。三维序列诊断急性心肌炎的敏感性和特异性分别为74%(95%置信区间[CI] 49-91%)和83%(36-100%),估计c统计量(95% CI)为0.85(0.79-0.91),二维和三维序列在检测急性心肌炎的T1(p=0.2207)或T2(p=1.0000)方面无显著统计学差异:结论:自由呼吸全心三维联合 T1/T2 造影在诊断性能方面与二维造影序列相当,但具有自由呼吸和扫描时间短的额外优势。需要进一步努力解决高 T1 值时出现的偏差,但这对诊断准确性没有显著影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of Myocarditis with a Free-breathing 3D Isotropic Whole-Heart Joint T1 and T2 Mapping Sequence.

Background: The diagnosis of myocarditis by CMR requires the use of T2 and T1 weighted imaging, ideally incorporating parametric mapping. Current 2D mapping sequences are acquired sequentially and involve multiple breath-holds resulting in prolonged scan times and anisotropic image resolution. We developed an isotropic free-breathing 3D whole-heart sequence which allows simultaneous T1 and T2 mapping and validated it in patients with suspected acute myocarditis.

Methods: Eighteen healthy volunteers and 28 patients with suspected myocarditis underwent conventional 2D T1 and T2 mapping with whole heart coverage and 3D joint T1/T2 mapping on a 1.5T scanner. Acquisition time, image quality, and diagnostic performance were compared. Qualitative analysis was performed using a 4-point Likert scale. Bland-Altman plots were used to assess the quantitative agreement between 2D and 3D sequences.

Results: The 3D T1/T2 sequence was acquired in 8mins 26s under free breathing, whereas 2D T1 and T2 sequences were acquired with breath holds in 11mins 44s (p=0.0001). All 2D images were diagnostic. For 3D images, 89% of T1 and 96% of T2 images were diagnostic with no significant difference in the proportion of diagnostic images for the 3D and 2D T1 (p=0.2482) and T2 maps (p=1.0000). Systematic bias in T1 was noted with biases of 102ms, 115ms, and 152ms for basal-apical segments, with a larger bias for higher T1 values. Good agreement between T2 values for 3D and 2D techniques was found (bias of 1.8ms, 3.9ms, and 3.6ms for basal-apical segments). The sensitivity and specificity of the 3D sequence for diagnosing acute myocarditis was 74% (95% confidence interval [CI] 49-91%) and 83% (36-100%) respectively, with an estimated c-statistic (95% CI) of 0.85 (0.79-0.91) and no statistically significant difference between the 2D and 3D sequences for the detection of acute myocarditis for T1 (p=0.2207) or T2 (p=1.0000).

Conclusion: Free-breathing whole heart 3D joint T1/T2 mapping was comparable to 2D mapping sequences with respect to diagnostic performance, but with the added advantages of free-breathing, and shorter scan times. Further work is required to address the bias noted at high T1 values, but this did not significantly impact on diagnostic accuracy.

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来源期刊
CiteScore
10.90
自引率
12.50%
发文量
61
审稿时长
6-12 weeks
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.
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