使用宽带灌注脉冲序列对植入心脏除颤器的患者在压力和休息时的心肌血流进行量化:初步可行性研究。

IF 6.1 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Lexiaozi Fan, Maria Davo Jimenez, Dima Bishara, Jacqueline Urban, Kyungpyo Hong, Austin E Culver, Jeremy D Collins, Li-Yueh Hsu, Shuo Wang, Amit R Patel, Oluyemi B Aboyewa, Cagdas Topel, Daniel C Lee, Daniel Kim
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引用次数: 0

摘要

背景:尽管最近开发的宽带灌注序列显示出诊断上可接受的图像质量和心脏植入电子设备(CIEDs)患者静止时准确的心肌血流量(MBF)量化,但其在血管扩张剂应激下的表现仍未得到证实。本研究旨在确定该序列是否在应激状态下产生诊断上可接受的图像质量,并能够定量检测植入心脏除颤器(ICDs)患者的异常应激MBF和心肌灌注储备(MPR)。方法:我们招募了29例ICD患者(平均年龄= 63±15岁,男性17例,女性12例)和11例对照患者(平均年龄= 50±17岁,男性6例,女性5例;冠状动脉疾病阴性;负应激灌注CMR; CMR后一年无心脏事件),将ICD贴在左锁骨下方以模拟图像伪影。两组在腺苷应激和静息时均采用六倍加速宽带灌注序列进行成像。利用压缩感知框架重构图像。两名临床读者按照5分李克特量表(1分最差,3分临床可接受,5分最佳)对以下三类进行独立评分:壁增强的显著性、噪音和伪影。逐像素应力-休息MBF图被量化,用于全局和分段分析。MPR计算为平均应力与静息mbf的比值。结果:两组患者的中位视力评分均高于可接受临界值(>9.0),两组间差异无统计学意义。ICD患者组整体和节段平均应激MBF和MPR(整体MBF=1.79±0.50ml/g/min,整体MPR=2.11±0.53)均显著低于对照组(整体MBF=2.92±0.52ml/g/min,整体MPR=3.28±0.57),而休息MBF无显著差异(患者组整体MBF=0.88±0.18ml/g/min,对照组0.92±0.13ml/g/min)。结论:本研究证明了使用六倍加速宽带灌注脉冲序列的可行性,该序列在应激期间提供诊断可接受的图像质量,并且对检测icd患者异常应激MBF和MPR敏感。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Myocardial Blood Flow Quantification in Patients with an Implanted Cardiodefibrillator during Stress and at Rest using a Wideband Perfusion Pulse Sequence: An Initial Feasibility Study.

Background: Although a recently developed wideband perfusion sequence has shown diagnostically acceptable image quality and accurate myocardial blood flow (MBF) quantification at rest in patients with cardiac implanted electronic devices (CIEDs), its performance during vasodilator stress remains unproven. This study aims to determine whether the sequence produces diagnostically acceptable image quality during stress and is capable of quantitatively detecting abnormal stress MBF and myocardial perfusion reserve (MPR) in patients with implanted cardiodefibrillators (ICDs).

Methods: We enrolled 29 patients with an ICD (mean age = 63 ± 15 years, 17 males, 12 females) and 11 control patients (mean age = 50 ± 17 years, 6 males, 5 females; negative coronary artery disease; negative stress perfusion CMR; and no cardiac event one year post CMR) with an ICD taped below the left clavicle to mimic image artifacts. Both groups underwent imaging using a six-fold accelerated wideband perfusion sequence during adenosine stress and at rest. Images were reconstructed using a compressed sensing framework. Two clinical readers independently graded the following three categories on a 5-point Likert scale (1: worst, 3: clinically acceptable, 5: best): conspicuity of wall enhancement, noise, and artifact. Pixel-wise stress-rest MBF maps were quantified for both global and segmental analysis. MPR was calculated as the ratio of mean stress to rest MBFs.

Results: The median summed visual score was above the acceptable cut-point (>9.0) and not significantly different between the two groups. Both mean global and segmental stress MBF and MPR were significantly lower (p < 0.05) in the ICD patient group (global MBF=1.79±0.50ml/g/min; global MPR=2.11±0.53) compared to the control group (global MBF=2.92±0.52ml/g/min; global MPR=3.28±0.57), while rest MBF showed no significant difference (global MBF=0.88±0.18ml/g/min in the patient group vs. 0.92±0.13ml/g/min in the control group).

Conclusions: This study demonstrates the feasibility of using a six-fold accelerated wideband perfusion pulse sequence, which provides diagnostically acceptable image quality during stress and is sensitive for detecting abnormal stress MBF and MPR in patients with ICDs.

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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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