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Temporal and spatial characteristics of the area at risk investigated using computed tomography and T1-weighted magnetic resonance imaging

vanderPals, Jesper LU ; Hammer-Hansen, Sophia; Nielles-Vallespin, Sonia; Kellman, Peter; Taylor, Joni; Kozlov, Shawn; Hsu, Li-Yueh; Chen, Marcus Y and Arai, Andrew E (2015) In European Heart Journal Cardiovascular Imaging 16(11). p.40-1232
Abstract

AIMS: Cardiovascular magnetic resonance (CMR) imaging can measure the myocardial area at risk (AAR), but the technique has received criticism for inadequate validation. CMR commonly depicts an AAR that is wider than the infarct, which in turn would require a lateral perfusion gradient within the AAR. We investigated the presence of a lateral perfusion gradient within the AAR and validated CMR measures of AAR against three independent reference standards of high quality.

METHODS AND RESULTS: Computed tomography (CT) perfusion imaging, microsphere blood flow analysis, T1-weighted 3T CMR and fluorescent microparticle pathology were used to investigate the AAR in a canine model (n = 10) of ischaemia and reperfusion. AAR size by CMR... (More)

AIMS: Cardiovascular magnetic resonance (CMR) imaging can measure the myocardial area at risk (AAR), but the technique has received criticism for inadequate validation. CMR commonly depicts an AAR that is wider than the infarct, which in turn would require a lateral perfusion gradient within the AAR. We investigated the presence of a lateral perfusion gradient within the AAR and validated CMR measures of AAR against three independent reference standards of high quality.

METHODS AND RESULTS: Computed tomography (CT) perfusion imaging, microsphere blood flow analysis, T1-weighted 3T CMR and fluorescent microparticle pathology were used to investigate the AAR in a canine model (n = 10) of ischaemia and reperfusion. AAR size by CMR correlated well with CT (R(2) = 0.80), microsphere blood flow (R(2) = 0.80), and pathology (R(2) = 0.74) with good limits of agreement [-0.79 ± 4.02% of the left ventricular mass (LVM) vs. CT; -1.49 ± 4.04% LVM vs. blood flow and -1.01 ± 4.18% LVM vs. pathology]. The lateral portion of the AAR had higher perfusion than the core of the AAR by CT perfusion imaging (40.7 ± 11.8 vs. 25.2 ± 17.7 Hounsfield units, P = 0.0008) and microsphere blood flow (0.11 ± 0.04 vs. 0.05 ± 0.02 mL/g/min, lateral vs. core, P = 0.001). The transmural extent of MI was lower in the lateral portion of the AAR than the core (28.2 ± 10.2 vs. 17.4 ± 8.4% of the wall, P = 0.001).

CONCLUSION: T1-weighted CMR accurately quantifies size of the AAR with excellent agreement compared with three independent reference standards. A lateral perfusion gradient results in lower transmural extent of infarction at the edges of the AAR compared with the core.

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author
publishing date
type
Contribution to journal
publication status
published
keywords
Animals, Contrast Media, Disease Models, Animal, Dogs, Flow Cytometry, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Cine, Microspheres, Myocardial Infarction, Time Factors, Tomography, X-Ray Computed, Journal Article, Research Support, N.I.H., Intramural
in
European Heart Journal Cardiovascular Imaging
volume
16
issue
11
pages
9 pages
publisher
Oxford University Press
external identifiers
  • scopus:84948709235
ISSN
2047-2412
DOI
10.1093/ehjci/jev072
language
English
LU publication?
no
id
7d9f9ebc-af2b-40bf-9b3e-b22c4c785eb2
date added to LUP
2017-01-22 13:45:41
date last changed
2017-10-29 04:56:54
@article{7d9f9ebc-af2b-40bf-9b3e-b22c4c785eb2,
  abstract     = {<p>AIMS: Cardiovascular magnetic resonance (CMR) imaging can measure the myocardial area at risk (AAR), but the technique has received criticism for inadequate validation. CMR commonly depicts an AAR that is wider than the infarct, which in turn would require a lateral perfusion gradient within the AAR. We investigated the presence of a lateral perfusion gradient within the AAR and validated CMR measures of AAR against three independent reference standards of high quality.</p><p>METHODS AND RESULTS: Computed tomography (CT) perfusion imaging, microsphere blood flow analysis, T1-weighted 3T CMR and fluorescent microparticle pathology were used to investigate the AAR in a canine model (n = 10) of ischaemia and reperfusion. AAR size by CMR correlated well with CT (R(2) = 0.80), microsphere blood flow (R(2) = 0.80), and pathology (R(2) = 0.74) with good limits of agreement [-0.79 ± 4.02% of the left ventricular mass (LVM) vs. CT; -1.49 ± 4.04% LVM vs. blood flow and -1.01 ± 4.18% LVM vs. pathology]. The lateral portion of the AAR had higher perfusion than the core of the AAR by CT perfusion imaging (40.7 ± 11.8 vs. 25.2 ± 17.7 Hounsfield units, P = 0.0008) and microsphere blood flow (0.11 ± 0.04 vs. 0.05 ± 0.02 mL/g/min, lateral vs. core, P = 0.001). The transmural extent of MI was lower in the lateral portion of the AAR than the core (28.2 ± 10.2 vs. 17.4 ± 8.4% of the wall, P = 0.001).</p><p>CONCLUSION: T1-weighted CMR accurately quantifies size of the AAR with excellent agreement compared with three independent reference standards. A lateral perfusion gradient results in lower transmural extent of infarction at the edges of the AAR compared with the core.</p>},
  author       = {vanderPals, Jesper and Hammer-Hansen, Sophia and Nielles-Vallespin, Sonia and Kellman, Peter and Taylor, Joni and Kozlov, Shawn and Hsu, Li-Yueh and Chen, Marcus Y and Arai, Andrew E},
  issn         = {2047-2412},
  keyword      = {Animals,Contrast Media,Disease Models, Animal,Dogs,Flow Cytometry,Image Processing, Computer-Assisted,Magnetic Resonance Imaging, Cine,Microspheres,Myocardial Infarction,Time Factors,Tomography, X-Ray Computed,Journal Article,Research Support, N.I.H., Intramural},
  language     = {eng},
  number       = {11},
  pages        = {40--1232},
  publisher    = {Oxford University Press},
  series       = {European Heart Journal Cardiovascular Imaging},
  title        = {Temporal and spatial characteristics of the area at risk investigated using computed tomography and T1-weighted magnetic resonance imaging},
  url          = {http://dx.doi.org/10.1093/ehjci/jev072},
  volume       = {16},
  year         = {2015},
}