Feasibility of gray-blood late gadolinium enhancement evaluation in young patients with congenital and acquired heart disease.
| Autor: | Gonzalez de Alba C; Division of Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado, Aurora, CO, United States., Moghari MH; Department of Radiology, University of Colorado, Aurora, CO, United States.; Department of Radiology, Children's Hospital Colorado, Aurora, CO, United States., Browne LP; Department of Radiology, University of Colorado, Aurora, CO, United States.; Department of Radiology, Children's Hospital Colorado, Aurora, CO, United States., Friesen RM; Division of Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado, Aurora, CO, United States., Fonseca B; Division of Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado, Aurora, CO, United States., Malone LJ; Department of Radiology, University of Colorado, Aurora, CO, United States.; Department of Radiology, Children's Hospital Colorado, Aurora, CO, United States. |
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| Jazyk: | angličtina |
| Zdroj: | Frontiers in cardiovascular medicine [Front Cardiovasc Med] 2023 Oct 17; Vol. 10, pp. 1269412. Date of Electronic Publication: 2023 Oct 17 (Print Publication: 2023). |
| DOI: | 10.3389/fcvm.2023.1269412 |
| Abstrakt: | Background: Late gadolinium enhancement (LGE) sequences have become common in pediatric cardiovascular magnetic resonance (CMR) to assess for myocardial fibrosis. Bright-blood late gadolinium enhancement (BB-LGE) by conventional phase-sensitive inversion recovery (PSIR) is commonly utilized, but similar inversion time (TI) value of fibrosis and left ventricular (LV) blood pool can make subendocardial areas difficult to assess. A gray-blood LGE (GB-LGE) technique has been described, targeting nulling of the LV blood pool and demonstrating improvement in ischemic scar detection over BB-LGE in adult patients. We sought to evaluate the feasibility of the GB-LGE technique in a young population with congenital and acquired heart disease and compare its ability to detect subendocardial scar to conventional BB-LGE. Methods: Seventy-six consecutive patients referred for clinical CMR underwent both BB-LGE and GB-LGE on 1.5 T and 3 T scanners. Conventional PSIR sequences were obtained with TI to null the myocardium (BB-LGE) in short-axis and horizontal long-axis stacks. Same PSIR stacks were immediately repeated with TI to null the blood pool (GB-LGE). Both sequences were reviewed separately a week apart by two readers, blinded to the initial clinical interpretation. Studies were analyzed for overall image quality, confidence in scar detection, confidence in detection of LGE, LGE class, inter- and intra-observer agreement for the presence of scar, and intraclass correlation coefficient (ICC) for total scar burden. Results: Overall confidence in myocardial scar detection by BB-LGE or GB-LGE as well as grading of image quality were not statistically different [( p = 1 and p = 1) and ( p = 0.53, p = 0.18), respectively]. There was very good inter-observer agreement for the presence of scar on BB-LGE ( K = 0.88, 95% CI 0.77-0.99) and GB-LGE ( K = 0.84, 95% CI 0.7-0.96), as well as excellent intra-observer agreement for both readers ( K = 0.93, 95% CI 0.87-0.99; and K = 0.81, 95% CI 0.69-0.95). Interclass correlation coefficient for total scar burden was excellent for BB-LGE (ICC = 0.98, 95% CI 0.96-0.99) and GB-LGE (ICC = 0.94, 95% CI 0.91-0.97). Conclusions: The GB-LGE technique is feasible in the pediatric population with congenital and acquired heart disease. It can detect subendocardial/ischemic scar similar to conventional bright-blood PSIR sequences in the pediatric population. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2023 Gonzalez de Alba, Moghari, Browne, Friesen, Fonseca and Malone.) |
| Databáze: | MEDLINE |
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