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In vivo contrast free chronic myocardial infarction characterization using diffusion-weighted cardiovascular magnetic resonance

BACKGROUND: Despite the established role of late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) in characterizing chronic myocardial infarction (MI), a significant portion of chronic MI patients are contraindicative for the use of contrast agents. One promising alternative cont...

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Autores principales: Nguyen, Christopher, Fan, Zhaoyang, Xie, Yibin, Dawkins, James, Tseliou, Eleni, Bi, Xiaoming, Sharif, Behzad, Dharmakumar, Rohan, Marbán, Eduardo, Li, Debiao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4167272/
https://www.ncbi.nlm.nih.gov/pubmed/25230598
http://dx.doi.org/10.1186/s12968-014-0068-y
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author Nguyen, Christopher
Fan, Zhaoyang
Xie, Yibin
Dawkins, James
Tseliou, Eleni
Bi, Xiaoming
Sharif, Behzad
Dharmakumar, Rohan
Marbán, Eduardo
Li, Debiao
author_facet Nguyen, Christopher
Fan, Zhaoyang
Xie, Yibin
Dawkins, James
Tseliou, Eleni
Bi, Xiaoming
Sharif, Behzad
Dharmakumar, Rohan
Marbán, Eduardo
Li, Debiao
author_sort Nguyen, Christopher
collection PubMed
description BACKGROUND: Despite the established role of late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) in characterizing chronic myocardial infarction (MI), a significant portion of chronic MI patients are contraindicative for the use of contrast agents. One promising alternative contrast free technique is diffusion weighted CMR (dwCMR), which has been shown ex vivo to be sensitive to myocardial fibrosis. We used a recently developed in vivo dwCMR in chronic MI pigs to compare apparent diffusion coefficient (ADC) maps with LGE imaging for infarct characterization. METHODS: In eleven mini pigs, chronic MI was induced by complete occlusion of the left anterior descending artery for 150 minutes. LGE, cine, and dwCMR imaging was performed 8 weeks post MI. ADC maps were derived from three orthogonal diffusion directions (b = 400 s/mm(2)) and one non-diffusion weighted image. Two semi-automatic infarct classification methods, threshold and full width half max (FWHM), were performed in both LGE and ADC maps. Regional wall motion (RWM) analysis was performed and compared to ADC maps to determine if any observed ADC change was significantly influenced by bulk motion. RESULTS: ADC of chronic MI territories was significantly increased (threshold: 2.4 ± 0.3 μm(2)/ms, FWHM: 2.4 ± 0.2 μm(2)/ms) compared to remote myocardium (1.4 ± 0.3 μm(2)/ms). RWM was significantly reduced (threshold: 1.0 ± 0.4 mm, FWHM: 0.9 ± 0.4 mm) in infarcted regions delineated by ADC compared to remote myocardium (8.3 ± 0.1 mm). ADC-derived infarct volume and location had excellent agreement with LGE. Both LGE and ADC were in complete agreement when identifying transmural infarcts. Additionally, ADC was able to detect LGE-delineated infarcted segments with high sensitivity, specificity, PPV, and NPV. (threshold: 0.88, 0.93, 0.87, and 0.94, FWHM: 0.98, 0.97, 0.93, and 0.99, respectively). CONCLUSIONS: In vivo diffusion weighted CMR has potential as a contrast free alternative for LGE in characterizing chronic MI.
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spelling pubmed-41672722014-09-19 In vivo contrast free chronic myocardial infarction characterization using diffusion-weighted cardiovascular magnetic resonance Nguyen, Christopher Fan, Zhaoyang Xie, Yibin Dawkins, James Tseliou, Eleni Bi, Xiaoming Sharif, Behzad Dharmakumar, Rohan Marbán, Eduardo Li, Debiao J Cardiovasc Magn Reson Research BACKGROUND: Despite the established role of late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) in characterizing chronic myocardial infarction (MI), a significant portion of chronic MI patients are contraindicative for the use of contrast agents. One promising alternative contrast free technique is diffusion weighted CMR (dwCMR), which has been shown ex vivo to be sensitive to myocardial fibrosis. We used a recently developed in vivo dwCMR in chronic MI pigs to compare apparent diffusion coefficient (ADC) maps with LGE imaging for infarct characterization. METHODS: In eleven mini pigs, chronic MI was induced by complete occlusion of the left anterior descending artery for 150 minutes. LGE, cine, and dwCMR imaging was performed 8 weeks post MI. ADC maps were derived from three orthogonal diffusion directions (b = 400 s/mm(2)) and one non-diffusion weighted image. Two semi-automatic infarct classification methods, threshold and full width half max (FWHM), were performed in both LGE and ADC maps. Regional wall motion (RWM) analysis was performed and compared to ADC maps to determine if any observed ADC change was significantly influenced by bulk motion. RESULTS: ADC of chronic MI territories was significantly increased (threshold: 2.4 ± 0.3 μm(2)/ms, FWHM: 2.4 ± 0.2 μm(2)/ms) compared to remote myocardium (1.4 ± 0.3 μm(2)/ms). RWM was significantly reduced (threshold: 1.0 ± 0.4 mm, FWHM: 0.9 ± 0.4 mm) in infarcted regions delineated by ADC compared to remote myocardium (8.3 ± 0.1 mm). ADC-derived infarct volume and location had excellent agreement with LGE. Both LGE and ADC were in complete agreement when identifying transmural infarcts. Additionally, ADC was able to detect LGE-delineated infarcted segments with high sensitivity, specificity, PPV, and NPV. (threshold: 0.88, 0.93, 0.87, and 0.94, FWHM: 0.98, 0.97, 0.93, and 0.99, respectively). CONCLUSIONS: In vivo diffusion weighted CMR has potential as a contrast free alternative for LGE in characterizing chronic MI. BioMed Central 2014-09-17 /pmc/articles/PMC4167272/ /pubmed/25230598 http://dx.doi.org/10.1186/s12968-014-0068-y Text en © Nguyen et al.; licensee BioMed Central Ltd. 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Nguyen, Christopher
Fan, Zhaoyang
Xie, Yibin
Dawkins, James
Tseliou, Eleni
Bi, Xiaoming
Sharif, Behzad
Dharmakumar, Rohan
Marbán, Eduardo
Li, Debiao
In vivo contrast free chronic myocardial infarction characterization using diffusion-weighted cardiovascular magnetic resonance
title In vivo contrast free chronic myocardial infarction characterization using diffusion-weighted cardiovascular magnetic resonance
title_full In vivo contrast free chronic myocardial infarction characterization using diffusion-weighted cardiovascular magnetic resonance
title_fullStr In vivo contrast free chronic myocardial infarction characterization using diffusion-weighted cardiovascular magnetic resonance
title_full_unstemmed In vivo contrast free chronic myocardial infarction characterization using diffusion-weighted cardiovascular magnetic resonance
title_short In vivo contrast free chronic myocardial infarction characterization using diffusion-weighted cardiovascular magnetic resonance
title_sort in vivo contrast free chronic myocardial infarction characterization using diffusion-weighted cardiovascular magnetic resonance
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4167272/
https://www.ncbi.nlm.nih.gov/pubmed/25230598
http://dx.doi.org/10.1186/s12968-014-0068-y
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