Aurelien Bustin, Victor de Villedon de Naide, Edouard Gerbaud, Thaïs Génisson, Kalvin Narceau, Théo Richard, Konstantinos Vlachos, Guido Caluori, Claire Bazin, Soumaya Sridi, Ilyes Benlala, Gael Dournes, Maxime Sermesant, Michel Montaudon, Pierre Jaïs, Matthias Stuber, Hubert Cochet
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This study evaluates SPOT-MAPPING, a sequence that acquires co-registered T2 maps and dual bright- and black-blood late gadolinium enhancement (LGE) images in a single scan.</p><p><strong>Methods and results: </strong>SPOT-MAPPING employs a single-shot, ECG-triggered 2D sequence alternating between bright- and black-blood LGE imaging with varying T2 weightings. We prospectively enrolled 20 STEMI patients undergoing CMR at 1.5 T within 4-7 days post-emergent coronary intervention. SPOT-MAPPING's segmentation times and reproducibility of myocardial injury markers (oedema, scar size, transmurality, papillary muscle damage) were assessed against conventional T2 mapping and phase-sensitive inversion recovery (PSIR). SPOT-MAPPING halved left ventricular wall segmentation time (∼3 min) while maintaining high reproducibility for oedema, scar size, and transmurality (ICC > 0.8). It improved papillary muscle damage detection over PSIR (8 vs. 3 patients) and showed comparable T2 values with conventional T2 mapping (remote: 45.0 ± 3.6 ms vs. 45.9 ± 3.7 ms, <i>P</i> = 0.746; oedema: 67.6 ± 10.3 ms vs. 71.8 ± 8.6 ms, <i>P</i> = 0.373). Agreement with PSIR for scar quantification was strong (mean bias: volume +1.5 mL, size +2.9%, transmurality +2.8%). SPOT-MAPPING demonstrated higher inter- and intraobserver reproducibility for scar size as a percentage of oedema volume compared with PSIR combined with conventional T2 mapping (ICC = 0.98 vs. 0.89 and 0.93 vs. 0.85).</p><p><strong>Conclusion: </strong>SPOT-MAPPING offers a time-efficient and reproducible CMR method for myocardial injury assessment post-STEMI.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. 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It improved papillary muscle damage detection over PSIR (8 vs. 3 patients) and showed comparable T2 values with conventional T2 mapping (remote: 45.0 ± 3.6 ms vs. 45.9 ± 3.7 ms, <i>P</i> = 0.746; oedema: 67.6 ± 10.3 ms vs. 71.8 ± 8.6 ms, <i>P</i> = 0.373). Agreement with PSIR for scar quantification was strong (mean bias: volume +1.5 mL, size +2.9%, transmurality +2.8%). SPOT-MAPPING demonstrated higher inter- and intraobserver reproducibility for scar size as a percentage of oedema volume compared with PSIR combined with conventional T2 mapping (ICC = 0.98 vs. 0.89 and 0.93 vs. 0.85).</p><p><strong>Conclusion: </strong>SPOT-MAPPING offers a time-efficient and reproducible CMR method for myocardial injury assessment post-STEMI.</p>\",\"PeriodicalId\":94317,\"journal\":{\"name\":\"European heart journal. 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引用次数: 0
摘要
目的：在急性st段抬高型心肌梗死中，缺血和再灌注导致心肌级联损伤，可通过心脏磁共振（CMR）成像表征，包括凝血坏死、水肿、乳头状肌损伤、微血管阻塞和心内出血。传统的CMR方案需要执行多个序列和复杂的分析。这项研究评估了SPOT-MAPPING，这是一个序列，在一次扫描中获得共同注册的T2图谱和双亮血和黑血晚期钆增强（LGE）图像。方法和结果：点成像采用单次心电图触发的2D序列，在不同T2权重的亮血和黑血LGE成像之间交替进行。我们前瞻性地招募了20名STEMI患者，在紧急冠状动脉介入治疗后4-7天内接受1.5 T的CMR。与常规T2成像和相敏反转恢复（PSIR）相比，对点阵成像的分割时间和心肌损伤标志物（水肿、疤痕大小、跨壁性、乳头状肌损伤）的可重复性进行评估。点阵图缩短了左心室壁分割时间（~ 3分钟），同时保持了对水肿、疤痕大小和跨壁性的高再现性（ICC > 0.8）。与PSIR相比，它改善了乳头肌损伤的检测（8例对3例），T2值与常规T2测图相当（远程测图：45.0±3.6 ms对45.9±3.7 ms, P = 0.746；水肿：67.6±10.3 ms对71.8±8.6 ms, P = 0.373）。与PSIR在疤痕定量方面的一致性很强（平均偏差：体积+1.5 mL，大小+2.9%，跨壁性+2.8%）。与PSIR联合常规T2作图相比，斑点作图显示疤痕大小占水肿体积的百分比在观察者间和观察者内具有更高的再现性（ICC = 0.98对0.89,0.93对0.85）。结论：点成像为stemi后心肌损伤评估提供了一种高效、可重复的CMR方法。
One-click co-registered T2 mapping and dual black- and bright-blood late gadolinium enhancement MRI for comprehensive assessment of myocardial injury after acute STEMI.
Aims: In acute ST-segment elevation myocardial infarction, ischaemia and reperfusion lead to a cascade of myocardial injury that can be characterized by cardiac magnetic resonance (CMR) imaging, including coagulation necrosis, oedema, papillary muscle damage, microvascular obstruction, and intramyocardial haemorrhage. Conventional CMR protocols require multiple sequences to be performed and complicated analysis. This study evaluates SPOT-MAPPING, a sequence that acquires co-registered T2 maps and dual bright- and black-blood late gadolinium enhancement (LGE) images in a single scan.
Methods and results: SPOT-MAPPING employs a single-shot, ECG-triggered 2D sequence alternating between bright- and black-blood LGE imaging with varying T2 weightings. We prospectively enrolled 20 STEMI patients undergoing CMR at 1.5 T within 4-7 days post-emergent coronary intervention. SPOT-MAPPING's segmentation times and reproducibility of myocardial injury markers (oedema, scar size, transmurality, papillary muscle damage) were assessed against conventional T2 mapping and phase-sensitive inversion recovery (PSIR). SPOT-MAPPING halved left ventricular wall segmentation time (∼3 min) while maintaining high reproducibility for oedema, scar size, and transmurality (ICC > 0.8). It improved papillary muscle damage detection over PSIR (8 vs. 3 patients) and showed comparable T2 values with conventional T2 mapping (remote: 45.0 ± 3.6 ms vs. 45.9 ± 3.7 ms, P = 0.746; oedema: 67.6 ± 10.3 ms vs. 71.8 ± 8.6 ms, P = 0.373). Agreement with PSIR for scar quantification was strong (mean bias: volume +1.5 mL, size +2.9%, transmurality +2.8%). SPOT-MAPPING demonstrated higher inter- and intraobserver reproducibility for scar size as a percentage of oedema volume compared with PSIR combined with conventional T2 mapping (ICC = 0.98 vs. 0.89 and 0.93 vs. 0.85).
Conclusion: SPOT-MAPPING offers a time-efficient and reproducible CMR method for myocardial injury assessment post-STEMI.
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