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3.0T Contrast-enhanced whole-heart coronary magnetic resonance angiography for simultaneous coronary artery angiography and myocardial viability in chronic myocardial infarction: A single-center preliminary study
To evaluate the accuracy of contrast-enhanced whole-heart magnetic resonance coronary angiography at 3.0T for assessing significant stenosis (≥50% lumen diameter reduction) in patients with myocardial infarction, by using conventional coronary artery angiography as the reference standard, and also t...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250500/ https://www.ncbi.nlm.nih.gov/pubmed/30407340 http://dx.doi.org/10.1097/MD.0000000000013138 |
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author | Chen, Zhiyong Sun, Bin Duan, Qing Xue, Yunjing Chen, Lianglong |
author_facet | Chen, Zhiyong Sun, Bin Duan, Qing Xue, Yunjing Chen, Lianglong |
author_sort | Chen, Zhiyong |
collection | PubMed |
description | To evaluate the accuracy of contrast-enhanced whole-heart magnetic resonance coronary angiography at 3.0T for assessing significant stenosis (≥50% lumen diameter reduction) in patients with myocardial infarction, by using conventional coronary artery angiography as the reference standard, and also test the performance of that for the detection and assessment of chronic myocardial infarction (MI), compared with standard delayed-enhancement coronary magnetic resonance (DE-CMR) for the determination of infarct size. We studied 42 consecutive patients (37 men, 5 women, mean age 58.5 ± 10.7 years) with MI scheduled for conventional coronary angiography. Contrast-enhanced whole-heart coronary magnetic resonance angiography (CMRA) was employed after sublingual nitroglycerin (NTG) with the abdominal banding rolled tightly along the side of ribs. Finally, a 3D phase-sensitive inversion-recovery gradient-echo (3D-PSIR-GRE) sequence was performed during free breathing. The assessment of MI sizes on WH-CMRA reconstructed images and 3D-PSIR-GRE images were compared using a paired student t test. The acquisition of CMRA was completed in 40 (95.2%) of 42 patients, with an imaging time averaged at 9.5 ± 3.1 minutes. The average navigator efficiency was 47%. The sensitivity, specificity, and positive and negative predictive values of whole-heart CMRA for the detection of significant lesions on a segment-by-segment analysis were 91.7% (95% confidence interval [CI] 83.8–96.1), 84.0% (95% CI 80.0–87.4), 57.9% (95% CI 50.0–65.8), 97.7% (95% CI 95.3–98.9), respectively, and on a patient-based analysis 93.5% (95% CI 77.2–98.9), 88.9% (95% CI 50.7–99.4), 96.7% (95% CI 80.9–99.8), and 80.0% (95% CI 44.2–96.5), respectively. Infarcts were generally higher on the CE-CMRA technique compared with the standard technique (18.0 ± 7.2 cm(3) vs 16.1 ± 6.4 cm(3); P < .0001). Contrast-enhanced whole-heart CMRA with 3.0-T not only may permit reliable detection of significant obstructive coronary artery disease in patients with myocardial infarction, but also could identify and quantify the volume of myocardial infarction. This technique could be considered the preferred approach in patients who could not overcome longer scanning times or unable to hold their breath instead of delayed-enhancement magnetic resonance imaging for detection of infarcted myocardium. However, compared with standard imaging, the volume of myocardial infarction is slightly overestimated. |
format | Online Article Text |
id | pubmed-6250500 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-62505002018-12-10 3.0T Contrast-enhanced whole-heart coronary magnetic resonance angiography for simultaneous coronary artery angiography and myocardial viability in chronic myocardial infarction: A single-center preliminary study Chen, Zhiyong Sun, Bin Duan, Qing Xue, Yunjing Chen, Lianglong Medicine (Baltimore) Research Article To evaluate the accuracy of contrast-enhanced whole-heart magnetic resonance coronary angiography at 3.0T for assessing significant stenosis (≥50% lumen diameter reduction) in patients with myocardial infarction, by using conventional coronary artery angiography as the reference standard, and also test the performance of that for the detection and assessment of chronic myocardial infarction (MI), compared with standard delayed-enhancement coronary magnetic resonance (DE-CMR) for the determination of infarct size. We studied 42 consecutive patients (37 men, 5 women, mean age 58.5 ± 10.7 years) with MI scheduled for conventional coronary angiography. Contrast-enhanced whole-heart coronary magnetic resonance angiography (CMRA) was employed after sublingual nitroglycerin (NTG) with the abdominal banding rolled tightly along the side of ribs. Finally, a 3D phase-sensitive inversion-recovery gradient-echo (3D-PSIR-GRE) sequence was performed during free breathing. The assessment of MI sizes on WH-CMRA reconstructed images and 3D-PSIR-GRE images were compared using a paired student t test. The acquisition of CMRA was completed in 40 (95.2%) of 42 patients, with an imaging time averaged at 9.5 ± 3.1 minutes. The average navigator efficiency was 47%. The sensitivity, specificity, and positive and negative predictive values of whole-heart CMRA for the detection of significant lesions on a segment-by-segment analysis were 91.7% (95% confidence interval [CI] 83.8–96.1), 84.0% (95% CI 80.0–87.4), 57.9% (95% CI 50.0–65.8), 97.7% (95% CI 95.3–98.9), respectively, and on a patient-based analysis 93.5% (95% CI 77.2–98.9), 88.9% (95% CI 50.7–99.4), 96.7% (95% CI 80.9–99.8), and 80.0% (95% CI 44.2–96.5), respectively. Infarcts were generally higher on the CE-CMRA technique compared with the standard technique (18.0 ± 7.2 cm(3) vs 16.1 ± 6.4 cm(3); P < .0001). Contrast-enhanced whole-heart CMRA with 3.0-T not only may permit reliable detection of significant obstructive coronary artery disease in patients with myocardial infarction, but also could identify and quantify the volume of myocardial infarction. This technique could be considered the preferred approach in patients who could not overcome longer scanning times or unable to hold their breath instead of delayed-enhancement magnetic resonance imaging for detection of infarcted myocardium. However, compared with standard imaging, the volume of myocardial infarction is slightly overestimated. Wolters Kluwer Health 2018-11-09 /pmc/articles/PMC6250500/ /pubmed/30407340 http://dx.doi.org/10.1097/MD.0000000000013138 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | Research Article Chen, Zhiyong Sun, Bin Duan, Qing Xue, Yunjing Chen, Lianglong 3.0T Contrast-enhanced whole-heart coronary magnetic resonance angiography for simultaneous coronary artery angiography and myocardial viability in chronic myocardial infarction: A single-center preliminary study |
title | 3.0T Contrast-enhanced whole-heart coronary magnetic resonance angiography for simultaneous coronary artery angiography and myocardial viability in chronic myocardial infarction: A single-center preliminary study |
title_full | 3.0T Contrast-enhanced whole-heart coronary magnetic resonance angiography for simultaneous coronary artery angiography and myocardial viability in chronic myocardial infarction: A single-center preliminary study |
title_fullStr | 3.0T Contrast-enhanced whole-heart coronary magnetic resonance angiography for simultaneous coronary artery angiography and myocardial viability in chronic myocardial infarction: A single-center preliminary study |
title_full_unstemmed | 3.0T Contrast-enhanced whole-heart coronary magnetic resonance angiography for simultaneous coronary artery angiography and myocardial viability in chronic myocardial infarction: A single-center preliminary study |
title_short | 3.0T Contrast-enhanced whole-heart coronary magnetic resonance angiography for simultaneous coronary artery angiography and myocardial viability in chronic myocardial infarction: A single-center preliminary study |
title_sort | 3.0t contrast-enhanced whole-heart coronary magnetic resonance angiography for simultaneous coronary artery angiography and myocardial viability in chronic myocardial infarction: a single-center preliminary study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250500/ https://www.ncbi.nlm.nih.gov/pubmed/30407340 http://dx.doi.org/10.1097/MD.0000000000013138 |
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