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김한웅 (Han W. Kim) 저자 이메일 보기
Duke University Medical Center
조회 210  인쇄하기 주소복사 트위터 공유 페이스북 공유 
Dark-Blood Delayed Enhancement Cardiac Magnetic Resonance of Myocardial Infarction
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Abstract

Objectives
This study introduced and validated a novel flow-independent delayed enhancement technique that shows hyperenhanced myocardium while simultaneously suppressing blood-pool signal.

Background
The diagnosis and assessment of myocardial infarction (MI) is crucial in determining clinical management and prognosis. Although delayed enhancement cardiac magnetic resonance (DE-CMR) is an in vivo reference standard for imaging MI, an important limitation is poor delineation between hyperenhanced myocardium and bright LV cavity blood-pool, which may cause many infarcts to become invisible.

Methods
A canine model with pathology as the reference standard was used for validation (n = 22). Patients with MI and normal controls were studied to ascertain clinical performance (n = 31).

Results
In canines, the flow-independent dark-blood delayed enhancement (FIDDLE) technique was superior to conventional DE-CMR for the detection of MI, with higher sensitivity (96% vs. 85%, respectively; p = 0.002) and accuracy (95% vs. 87%, respectively; p = 0.01) and with similar specificity (92% vs, 92%, respectively; p = 1.0). In infarcts that were identified by both techniques, the entire length of the endocardial border between infarcted myocardium and adjacent blood-pool was visualized in 33% for DE-CMR compared with 100% for FIDDLE. There was better agreement for FIDDLE-measured infarct size than for DE-CMR infarct size (95% limits-of-agreement, 2.1% vs. 5.5%, respectively; p < 0.0001). In patients, findings were similar. FIDDLE demonstrated higher accuracy for diagnosis of MI than DE-CMR (100% [95% confidence interval [CI]: 89% to 100%] vs. 84% [95% CI: 66% to 95%], respectively; p = 0.03).

Conclusions
The study introduced and validated a novel CMR technique that improves the discrimination of the border between infarcted myocardium and adjacent blood-pool. This dark-blood technique provides diagnostic performance that is superior to that of the current in vivo reference standard for the imaging diagnosis of MI.

Key Words
cardiac magnetic resonance; diagnosis; infarct size; myocardial infarction

논문정보
- 형식: Research article
- 게재일: 2018년 12월 (BRIC 등록일 2018-12-07)
- 연구진: 국외연구진
- 분야: Medicine
골수 줄기세포에서 전환분화한 표피세포와 피부 줄기세포의 피부암 및 궤양 발달의 역할과 기작[Nat. Commun.]
박희준
발표: 박희준 (Fred Hutchinson Cancer Research Cen...)
일자: 2019년 1월 22일 (화) 오전 10시 (한국시간)
언어: 한국어
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