Assessment of Myocardial Viability Using Delayed Enhancement Magnetic Resonance Imaging at 3.0 Tesla

Klumpp, Bernhard; Fenchel, Michael; Hoevelborn, Tobias; Helber, Uwe; Scheule, Albertus M.; Claussen, Claus D.; Miller, Stephan

doi:10.1097/01.rli.0000233321.82194.09

Cited by 69 publications

(46 citation statements)

References 28 publications

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“…priate for 3D viability imaging, or a phase-sensitive imaging technique may improve the image contrast of the free-breathing 3D viability imaging, while the present technique delineated MI and linear hyperenhancing myocardium (10,11,13,21,22). This freebreathing 3D viability imaging did not have isovoxels most appropriate for multiplanar reconstruction, although we believe that the present reconstructed images were sufficient for the detection of hyperenhancing myocardium (23).…”

Section: Discussionmentioning

confidence: 67%

“…In particular, the free-breathing 3D viability images delineated the MI (21/23 ϭ 91.3%) and all linear hyperenhancing myocardium, because of their high spatial resolution and the high CNR between LV blood and subendocardial hyperenhancing myocardium. This high CNR between the LV blood and hyperenhancing myocardium might be attributed to the suppression of blood signals because of the volumetric excitation and reduced inflow effect in the 3D viability imaging (13,15). Another possible reason for the high CNR between the LV blood and hyperenhancing myocardium was the washout of gadolinium from the LV blood because of the longer delay time and scan time of the free-breathing 3D viability imaging.…”

Section: Discussionmentioning

confidence: 99%

“…However, the spatial resolution of the freebreathing 3D viability MRI at 1.5T is not so high in the slice direction (e.g., 5 mm). The decrease in image quality because of thinner sections, higher receiver bandwidth (RBW), and shorter repetition time (TR) in freebreathing 3D viability imaging can be partly compensated for by high-field MR imagers through their inherently large magnetization (13). The purpose of this study was to evaluate the contrast-to-noise ratio (CNR) of hyperenhancing myocardium and feasibility of free-breathing high-spatial-resolution delayed contrast-enhanced 3D viability MRI at 3.0T.…”

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confidence: 99%

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Free‐breathing high‐spatial‐resolution delayed contrast‐enhanced three‐dimensional viability MR imaging of the myocardium at 3.0T: A feasibility study

Amano

Matsumura

Kumita

2008

Magnetic Resonance Imaging

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Purpose:To assess the feasibility of free-breathing highspatial-resolution delayed contrast-enhanced three-dimensional (3D) viability magnetic resonance imaging (MRI) at 3.0T for the detection of myocardial damages. Materials and Methods:Twenty-five patients with myocardial diseases, including myocardial infarction and cardiomyopathies, were enrolled after informed consent was given. Free-breathing 3D viability MRI with high spatial resolution (1.5 ϫ 1.25 ϫ 2.5 mm) at 3.0T, for which cardiac and navigator gating techniques were employed, was compared with breath-hold two-dimensional (2D) viability imaging (1.77 ϫ 1.18 ϫ 10 mm) for assessment of contrastto-noise ratio (CNR) and myocardial damage.Results: Free-breathing 3D viability imaging was achieved successfully in 21 of the 25 patients. This imaging technique depicted 84.6% of hyperenhancing myocardium with a higher CNR between hyperenhancing myocardium and blood and with excellent agreement for the transmural extension of myocardial damage (k ϭ 0.91). In particular, the 3D viability images delineated the myocardial infarction and linear hyperenhancing myocardium, comparable to the 2D viability images. Conclusion:Free-breathing high-spatial-resolution delayed contrast-enhanced 3D viability MRI using 3.0T was feasible for the evaluation of hyperenhancing myocardium, as seen with myocardial infarction and cardiomyopathies.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Free‐breathing high‐spatial‐resolution delayed contrast‐enhanced three‐dimensional viability MR imaging of the myocardium at 3.0T: A feasibility study

Amano

Matsumura

Kumita

2008

Magnetic Resonance Imaging

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“…Particularly, the BZ area increases in proportion to the spatial resolution because of partial volume averaging. 21 Delayed-enhancement MRI at 3.0 T provides significantly higher spatial resolution than does 1.5 T. 22 Slice thickness ranged from 5 to 8 mm in previous reports. 5,13,20 The spatial resolution of 1.4 isotropic voxel size in this study allowed a more accurate visualization of the width and trajectory of the BZ channels.…”

Section: Image Acquisition and Postprocessingmentioning

confidence: 99%

Three-Dimensional Architecture of Scar and Conducting Channels Based on High Resolution ce-CMR

Fernández-Armenta

Berruezo

Andreu

et al. 2013

Circ: Arrhythmia and Electrophysiology

186

128

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Background-Conducting channels are the target for ventricular tachycardia (VT) ablation. Conducting channels could be identified with contrast enhanced-cardiac magnetic resonance (ce-CMR) as border zone (BZ) corridors. A 3-dimensional (3D) reconstruction of the ce-CMR could allow visualization of the 3D structure of these BZ channels. Methods and Results-We included 21 patients with healed myocardial infarction and VT. A 3D high-resolution 3T ce-CMR was performed before CARTO-guided VT ablation. The left ventricular wall was segmented and characterized using a pixel signal intensity algorithm at 5 layers (endocardium, 25%, 50%, 75%, epicardium). A 3D color-coded shell map was obtained for each layer to depict the scar core and BZ distribution. The presence/characteristics of BZ channels were registered for each layer. Scar area decreased progressively from endocardium to epicardium (scar area/left ventricular area: 34.0±17.4% at endocardium, 24.1±14.7% at 25%, 16.3±12.1% at 50%, 13.1±10.4 at 75%, 12.1±9.3% at epicardium; P<0.01). Forty-five BZ channels (2.1±1.0 per patient, 23.7±12.0 mm length, mean minimum width 2.5±1.5 mm) were identified, 85% between the endocardium and 50% shell and 76% present in ≥1 layer. The ce-CMR-defined BZ channels identified 74% of the critical isthmus of clinical VTs and 50% of all the conducting channels identified in electroanatomic maps. Conclusions-Scar area in patients with healed myocardial infarction decreases from the endocardium to the epicardium.BZ channels, more commonly seen in the endocardium, display a 3D structure within the myocardial wall that can be depicted with ce-CMR. The use of ce-CMR-derived maps to guide VT ablation warrants further investigation.

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“…Many theoretical advantages of high-field imaging directly translate into improved image quality for cardiac applications, e.g. myocardial perfusion [4,7] and viability imaging [5,8]. Myocardial tagging has been shown to benefit from 3 T imaging because of an increased signal-to-noise ratio (SNR) and prolonged T 1 relaxation time, resulting in better tag definition and longer tag persistence in healthy volunteers [3,9].…”

mentioning

confidence: 99%

Dobutamine stress tagging and gradient-echo imaging for detection of coronary heart disease at 3 T

Thomas

Meyer²,

Strach³

et al. 2011

BJR

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Objective: The purpose of this study was to evaluate the feasibility and diagnostic accuracy of a combined spoiled gradient-echo (sGRE) and tagged gradient-echo (SPAMM-GRE) protocol for detection of coronary artery disease (CAD) during high-dose dobutamine stress at 3 T. Method: The study protocol was approved by the local ethics committee. For stress testing, a standard high-dose dobutamine protocol was employed. Image quality at the highest stress level and diagnostic accuracy of the sGRE and SPAMM-GRE sequences were comparedThe final study population consisted of 37 patients. Results: The mean image quality score was 2.6¡0.6 for the sGRE sequence and 2.4¡0.6 for the SPAMM-GRE sequence (p.0.05). Sensitivity, specificity and diagnostic accuracy were 0.81, 0.86, 0.84 and 0.88, 0.86, 0.86 for the sGRE and SPAMM-GRE, respectively. In three cases with new wall motion abnormalities (WMAs), detected by sGRE and SPAMM-GRE, WMAs were detected at a lower stress level by tagging. Conclusion:The combined sGRE and SPAMM-GRE high-dose dobutamine protocol at 3 T is feasible and delivers good diagnostic accuracy. Tagging increases the sensitivity of high-dose dobutamine stress testing for detection of CAD and may allow for detection of new WMAs at lower stress levels compared with sGRE alone.

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Assessment of Myocardial Viability Using Delayed Enhancement Magnetic Resonance Imaging at 3.0 Tesla

Abstract: Delayed enhancement MRI at 3.0 T is feasible and provides superior image quality compared with 1.5 T. Furthermore, using identical contrast doses, increased SNR and CNR values were recorded at 3.0 T.

Cited by 69 publications

References 28 publications

Free‐breathing high‐spatial‐resolution delayed contrast‐enhanced three‐dimensional viability MR imaging of the myocardium at 3.0T: A feasibility study

Free‐breathing high‐spatial‐resolution delayed contrast‐enhanced three‐dimensional viability MR imaging of the myocardium at 3.0T: A feasibility study

Three-Dimensional Architecture of Scar and Conducting Channels Based on High Resolution ce-CMR

Dobutamine stress tagging and gradient-echo imaging for detection of coronary heart disease at 3 T

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