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Quantitative T1 Mapping for Detecting Microvascular Obstruction in Reperfused Acute Myocardial Infarction: Comparison with Late Gadolinium Enhancement Imaging

 Jae Min Shin  ;  Eui Young Choi  ;  Chul Hwan Park  ;  Kyunghwa Han  ;  Tae Hoon Kim 
 KOREAN JOURNAL OF RADIOLOGY, Vol.21(8) : 978-986, 2020-08 
Journal Title
Issue Date
Adult ; Contrast Media ; Female ; Gadolinium ; Heart / diagnostic imaging* ; Humans ; Image Enhancement ; Magnetic Resonance Imaging, Cine / methods* ; Male ; Middle Aged ; Myocardial Infarction / diagnostic imaging* ; Myocardial Infarction / pathology* ; Myocardial Reperfusion Injury / diagnostic imaging* ; Myocardial Reperfusion Injury / pathology ; Myocardium / pathology
Cardiovascular magnetic resonance imaging ; Late gadolinium enhancing imaging ; Microvascular obstruction ; Myocardial infarction ; T1 mapping
Objective: To compare native and post-contrast T1 mapping with late gadolinium enhancement (LGE) imaging for detecting and measuring the microvascular obstruction (MVO) area in reperfused acute myocardial infarction (MI). Materials and methods: This study included 20 patients with acute MI who had undergone 1.5T cardiovascular magnetic resonance imaging (CMR) after reperfusion therapy. CMR included cine imaging, LGE, and T1 mapping (modified look-locker inversion recovery). MI size was calculated from LGE by full-width at half-maximum technique. MVO was defined as an area with low signal intensity (LGE) or as a region of visually distinguishable T1 values (T1 maps) within infarcted myocardium. Regional T1 values were measured in MVO, infarcted, and remote myocardium on T1 maps. MVO area was measured on and compared among LGE, native, and post-contrast T1 maps. Results: The mean MI size was 27.1 ± 9.7% of the left ventricular mass. Of the 20 identified MVOs, 18 (90%) were detected on native T1 maps, while 10 (50%) were recognized on post-contrast T1 maps. The mean native T1 values of MVO, infarcted, and remote myocardium were 1013.5 ± 58.5, 1240.9 ± 55.8 (p < 0.001), and 1062.2 ± 55.8 ms (p = 0.169), respectively, while the mean post-contrast T1 values were 466.7 ± 26.8, 399.1 ± 21.3, and 585.2 ± 21.3 ms, respectively (p < 0.001). The mean MVO areas on LGE, native, and post-contrast T1 maps were 134.1 ± 81.2, 133.7 ± 80.4, and 117.1 ± 53.3 mm², respectively. The median (interquartile range) MVO areas on LGE, native, and post-contrast T1 maps were 128.0 (58.1-215.4), 110.5 (67.7-227.9), and 143.0 (76.7-155.3) mm², respectively (p = 0.002). Concordance correlation coefficients for the MVO area between LGE and native T1 maps, LGE and post-contrast T1 maps, and native and post-contrast T1 maps were 0.770, 0.375, and 0.565, respectively. Conclusion: MVO areas were accurately delineated on native T1 maps and showed high concordance with the areas measured on LGE. However, post-contrast T1 maps had low detection rates and underestimated MVO areas. Collectively, native T1 mapping is a useful tool for detecting MVO within the infarcted myocardium.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-3598-2529
Park, Chul Hwan(박철환) ORCID logo https://orcid.org/0000-0002-0004-9475
Choi, Eui Young(최의영) ORCID logo https://orcid.org/0000-0003-3732-0190
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