High-resolution quantification of stress perfusion defects by cardiac magnetic resonance.

Autor:	Scannell CM; Department of Biomedical Engineering, Eindhoven University of Technology, Groene Loper 5, 5612 AE Eindhoven, The Netherlands.; School of Biomedical Engineering and Imaging Sciences, King's College London, London SE1 7EH, UK., Crawley R; School of Biomedical Engineering and Imaging Sciences, King's College London, London SE1 7EH, UK., Alskaf E; School of Biomedical Engineering and Imaging Sciences, King's College London, London SE1 7EH, UK., Breeuwer M; Department of Biomedical Engineering, Eindhoven University of Technology, Groene Loper 5, 5612 AE Eindhoven, The Netherlands., Plein S; School of Biomedical Engineering and Imaging Sciences, King's College London, London SE1 7EH, UK.; Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, UK., Chiribiri A; School of Biomedical Engineering and Imaging Sciences, King's College London, London SE1 7EH, UK.
Jazyk:	angličtina
Zdroj:	European heart journal. Imaging methods and practice [Eur Heart J Imaging Methods Pract] 2024 Jan 09; Vol. 2 (1), pp. qyae001. Date of Electronic Publication: 2024 Jan 09 (Print Publication: 2024).
DOI:	10.1093/ehjimp/qyae001
Abstrakt:	Aims: Quantitative stress perfusion cardiac magnetic resonance (CMR) is becoming more widely available, but it is still unclear how to integrate this information into clinical decision-making. Typically, pixel-wise perfusion maps are generated, but diagnostic and prognostic studies have summarized perfusion as just one value per patient or in 16 myocardial segments. In this study, the reporting of quantitative perfusion maps is extended from the standard 16 segments to a high-resolution bullseye. Cut-off thresholds are established for the high-resolution bullseye, and the identified perfusion defects are compared with visual assessment. Methods and Results: Thirty-four patients with known or suspected coronary artery disease were retrospectively analysed. Visual perfusion defects were contoured on the CMR images and pixel-wise quantitative perfusion maps were generated. Cut-off values were established on the high-resolution bullseye consisting of 1800 points and compared with the per-segment, per-coronary, and per-patient resolution thresholds. Quantitative stress perfusion was significantly lower in visually abnormal pixels, 1.11 (0.75-1.57) vs. 2.35 (1.82-2.9) mL/min/g (Mann-Whitney U test P < 0.001), with an optimal cut-off of 1.72 mL/min/g. This was lower than the segment-wise optimal threshold of 1.92 mL/min/g. The Bland-Altman analysis showed that visual assessment underestimated large perfusion defects compared with the quantification with good agreement for smaller defect burdens. A Dice overlap of 0.68 (0.57-0.78) was found. Conclusion: This study introduces a high-resolution bullseye consisting of 1800 points, rather than 16, per patient for reporting quantitative stress perfusion, which may improve sensitivity. Using this representation, the threshold required to identify areas of reduced perfusion is lower than for segmental analysis. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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