Magnetic Resonance Imaging of Myocardial Strain After Acute ST-Segment–Elevation Myocardial Infarction

Background Excessive trabeculation is present in isolated left ventricular noncompaction (LVNC) and dilated cardiomyopathy (DCM), which sometimes makes the differentiation between these two difficult. Fractal dimension (FD) is a unitless measure value of how completely the object fills space, which can assess the extent of myocardial trabeculae quantitatively. Purpose To compare the trabeculae features and myocardial strain derived from cardiac MR between LVNC and DCM. Study Type Respective case–control series. Population In all, 35 LVNC patients and 30 DCM patients were enrolled, and 20 healthy volunteers were selected as a control group. Field Strength/Sequence 5 T with 8‐channel phased‐array cardiac receiver coil including steady‐state free precession cine imaging. Assessment The degree of left ventricular trabeculation was evaluated by a semiautomatic tool based on fractal analysis. Myocardial deformation was assessed by feature tracking. Statistical Tests Independent samples Student's t‐test, Mann–Whitney U‐test, receiver operating characteristics (ROC) curves, and Spearman's rank coefficient were conducted. Results Max apical FD and mean global FD were higher in the LVNC group than in the DCM group (1.433 ± 0.074 vs. 1.341 ± 0.062, P < 0.001; 1.323 ± 0.036 vs. 1.267 ± 0.041, P < 0.001, respectively). For diagnosing LVNC, max apical FD was 1.392 (area under the curve [AUC] = 0.881, 95% confidence interval [CI]: 0.804–0.957), and the cutoff value of mean global FD was 1.283 (AUC = 0.895, 95% CI: 0.828–0.961). The global peak longitudinal strain value of the left ventricle (GPLS) showed significant differences between the LVNC group and DCM group [–6.49 (–11.41, –4.90) vs. –4.61 (–5.87, –3.61), P = 0.006]. The diagnostic accuracy for LVNC is highest when using FDs in coordination with GPLS (AUC = 0.93, 95% CI: 0.86–0.98, P < 0.001). Data Conclusion Fractal analysis provides a quantitative measurement of myocardial trabeculation. The combination of fractal analysis with myocardial strain provides a novel biomarker in distinguishing LVNC from DCM. Level of Evidence: 3 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:153–163.

Section: Discussionmentioning

confidence: 94%

Value of Cardiac Magnetic Resonance Fractal Analysis Combined With Myocardial Strain in Discriminating Isolated Left Ventricular Noncompaction and Dilated Cardiomyopathy

Zheng

et al. 2018

“…Harmonic phase analysis allows rapid analysis of the tagged images; however, spatial resolution and strain accuracy are reduced . SENC allows effective quantification of through‐plane strain but has limitations in complete coverage of radial and circumferential strain analysis . Furthermore, the myocardial motion velocity can also be directly interrogated using a black‐blood 3D phase‐contrast image sequence.…”

Section: Cancer Therapeutics‐related Cardiac Dysfunctionmentioning

confidence: 99%

“…Temporal resolution is similar, ~50 msec, across different strain measurement techniques . Retrospective strain analysis utilizing standard of care bSSFP images offers time‐efficient imaging with no need for additional breath‐held sequences.…”

Section: Cancer Therapeutics‐related Cardiac Dysfunctionmentioning

confidence: 99%

“…47 SENC allows effective quantification of through-plane strain but has limitations in complete coverage of radial and circumferential strain analysis. 48 Furthermore, the myocardial motion velocity can also be directly interrogated using a black-blood 3D phase-contrast image sequence. The strain rate can be directly computed from the resulting 3D velocity field.…”

Section: Ventricular Dysfunctionmentioning

confidence: 99%

“…54 Temporal resolution is similar,~50 msec, across different strain measurement techniques. 48 Retrospective strain analysis utilizing standard of care bSSFP images offers timeefficient imaging with no need for additional breath-held sequences. However, research sequences may benefit from potential increases in accuracy and precision than a dedicated strain sequence could offer.…”

Section: Ventricular Dysfunctionmentioning

confidence: 99%

See 2 more Smart Citations

MRI in cardio‐oncology: A review of cardiac complications in oncologic care

Jeong

Gladish

Chițiboi

et al. 2019

From detailed characterization of cardiac abnormalities to the assessment of cancer treatment‐related cardiac dysfunction, cardiac MRI is playing a growing role in the evaluation of cardiac pathology in oncology patients. Current guidelines are now incorporating the use of MRI for the comprehensive multidisciplinary approach to cancer management, and innovative applications of MRI in research are expanding its potential to provide a powerful noninvasive tool in the arsenal against cancer. This review focuses on the application of cardiac MRI to diagnose and manage cardiovascular complications related to cancer and its treatment. Following an introduction to current cardiac MRI methods and principles, this review is divided into two sections: functional cardiovascular analysis and anatomical or tissue characterization related to cancer and cancer therapeutics. Level of Evidence: 5 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2019;50:1349–1366.

Displacement Encoding With Stimulated Echoes Enables the Identification of Infarct Transmurality Early Postmyocardial Infarction

Mangion

Loughrey

Auger

et al. 2020

Self Cite

Background: Segmental extent of infarction assessed by late gadolinium enhancement (LGE) imaging early post-STsegment elevation myocardial infarction (STEMI) has utility in predicting left ventricular functional recovery. Hypothesis: We hypothesized that segmental circumferential strain with displacement encoding with stimulated echoes (DENSE) would be a stronger predictor of infarct transmurality than feature-tracking strain, and noninferior to extracellular volume fraction (ECV). Study Type: Prospective. Population: Fifty participants (mean AE SD, 59 AE 9 years, 40 [80%] male) underwent cardiac MRI on day 1 post-STEMI. Field-Strength/Sequences: 1.5T/cine, DENSE, T 1 mapping, ECV, LGE. Assessment: Two observers assessed segmental percentage LGE extent, presence of microvascular obstruction (MVO), circumferential and radial strain with DENSE and feature-tracking, T 1 relaxation times, and ECV. Statistical Tests: Normality was tested using the Shapiro-Wilk test. Skewed distributions were analyzed utilizing Mann-Whitney or Kruskal-Wallis tests and normal distributed data using independent t-tests. Diagnostic cutoff values were identified using the Youden index. The difference in area under the curve was compared using the z-statistic. Results: Segmental circumferential strain with DENSE was associated with the extent of infarction ≥50% (AUC [95% CI], cutoff value = 0.9 [0.8, 0.9], −10%) similar to ECV (AUC = 0.8 [0.8, 0.9], 37%) (P = 0.117) and superior to feature-tracking circumferential strain (AUC = 0.7[0.7, 0.8], −19%) (P < 0.05). For the detection of segmental infarction ≥75%, circumferential strain with DENSE (AUC = 0.9 [0.8, 0.9], −10%