Evaluating a novel accelerated free-breathing late gadolinium enhancement imaging sequence for assessment of myocardial injury.

Autor: Bhatt N; Faculty of Medicine, University of Toronto, Toronto, ON, Canada., Orbach A; Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada., Biswas L; Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada., Strauss BH; Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada., Connelly K; Division of Cardiology, St. Michael's Hospital, Toronto, ON, Canada., Ghugre NR; Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada., Wright GA; Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada., Roifman I; Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. Electronic address: idan.roifman@sunnybrook.ca.
Jazyk: angličtina
Zdroj: Magnetic resonance imaging [Magn Reson Imaging] 2024 May; Vol. 108, pp. 40-46. Date of Electronic Publication: 2024 Feb 02.
DOI: 10.1016/j.mri.2024.01.020
Abstrakt: Introduction: Cardiac magnetic resonance imaging (MRI), including late gadolinium enhancement (LGE), plays an important role in the diagnosis and prognostication of ischemic and non-ischemic myocardial injury. Conventional LGE sequences require patients to perform multiple breath-holds and require long acquisition times. In this study, we compare image quality and assessment of myocardial LGE using an accelerated free-breathing sequence to the conventional standard-of-care sequence.
Methods: In this prospective cohort study, a total of 41 patients post Coronavirus 2019 (COVID-19) infection were included. Studies were performed on a 1.5 Tesla scanner with LGE imaging acquired using a conventional inversion recovery rapid gradient echo (conventional LGE) sequence followed by the novel accelerated free-breathing (FB-LGE) sequence. Image quality was visually scored (ordinal scale from 1 to 5) and compared between conventional and free-breathing sequences using the Wilcoxon rank sum test. Presence of per-segment LGE was identified according to the American Heart Association 16-segment myocardial model and compared across both conventional LGE and FB-LGE sequences using a two-sided chi-square test. The perpatient LGE extent was also evaluated using both sequences and compared using the Wilcoxon rank sum test. Interobserver variability in detection of per-segment LGE and per-patient LGE extent was evaluated using Cohen's kappa statistic and interclass correlation (ICC), respectively.
Results: The mean acquisition time for the FB-LGE sequence was 17 s compared to 413 s for the conventional LGE sequence (P < 0.001). Assessment of image quality was similar between both sequences (P = 0.19). There were no statistically significant differences in LGE assessed using the FB-LGE versus conventional LGE on a per-segment (P = 0.42) and per-patient (P = 0.06) basis. Interobserver variability in LGE assessment for FB-LGE was good for per-segment (= 0.71) and per-patient extent (ICC = 0.92) analyses.
Conclusions: The accelerated FB-LGE sequence performed comparably to the conventional standard-of-care LGE sequence in a cohort of patients post COVID-19 infection in a fraction of the time and without the need for breath-holding. Such a sequence could impact clinical practice by increasing cardiac MRI throughput and accessibility for frail or acutely ill patients unable to perform breath-holding.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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