Quantification of myocardial infarct size and transmurality by contrast-enhanced magnetic resonance imaging in men
| Autor: | Theodorus A.M. Kaandorp, Joanne D. Schuijf, Ernst E. van der Wall, Albert de Roos, Rob J. van der Geest, Eric P. Viergever, Jeroen J. Bax, Hildo J. Lamb |
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| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Scar tissue Myocardial Infarction Contrast Media Magnetic Resonance Imaging Cine Infarction Sensitivity and Specificity Severity of Illness Index Sampling Studies Internal medicine Humans Medicine Prospective Studies cardiovascular diseases Myocardial infarction Wall motion Contrast-enhanced Magnetic Resonance Imaging Aged Probability Ejection fraction medicine.diagnostic_test business.industry Myocardium Magnetic resonance imaging Middle Aged medicine.disease Myocardial Contraction Radiographic Image Enhancement Heart Function Tests Linear Models Cardiology Cardiology and Cardiovascular Medicine business Wall thickness Nuclear medicine |
| Zdroj: | The American Journal of Cardiology. 94:284-288 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2004.04.020 |
| Popis: | Contrast-enhanced magnetic resonance (ce-MR) imaging allows precise delineation of infarct transmurality. An issue of debate is whether data analysis should be performed visually or quantitatively. Accordingly, a head-to-head comparison was performed between visual and quantitative analyses of infarct transmurality on ce-MR imaging. In addition, infarct transmurality was related to the severity of wall motion abnormalities at rest. In 27 patients with long-term ischemic left ventricular (LV) dysfunction (LV ejection fraction 33 ± 8%) and previous infarction, cine MR imaging (to assess regional wall motion) and ce-MR imaging were performed. Using a 17-segment model, each segment was assigned a wall motion score (from normokinesia to dyskinesia), and segmental infarct transmurality was visually assessed on a 5-point scale (0 = no infarction, 1 = transmurality ≤25% of LV wall thickness, 2 = transmurality 26% to 50%, 3 = transmurality 51% to 75%, and 4 = transmurality 76% to 100%). Quantification of transmurality was performed with threshold analysis; myocardium showing signal intensity above the threshold was considered scar tissue, and percent transmurality was calculated automatically. Wall motion was abnormal in 56% of the 459 segments, and 55% of segments showed hyperenhancement (indicating scar tissue). The agreement between visual and quantitative analyses was excellent: 90% of segments (κ 0.86) were categorized similarly by visual and quantitative analyses. Infarct transmurality paralleled the severity of contractile dysfunction; 96% of normal or mildly hypokinetic segments had infarct transmurality ≤25%, whereas 93% of akinetic and dyskinetic segments had transmurality >50% on visual analysis. In conclusion, visual analysis of ce-MR imaging studies may be sufficient for assessment of transmurality of infarction. |
| Databáze: | OpenAIRE |
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