Cardiovascular magnetic resonance imaging in ischemic heart disease

Knobelsdorff‐Brenkenhoff, Florian von; Schulz‐Menger, Jeanette

doi:10.1002/jmri.23580

Cited by 33 publications

(31 citation statements)

References 161 publications

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“…Late gadolinium enhancement (LGE) cardiac magnetic resonance (MR) imaging is a clinically established and accurate method for the assessment of ischemic myocardial scar (4,5). However, patients with coronary artery disease have a higher prevalence of coexisting chronic kidney disease compared with patients without coronary artery disease (6), which makes methods for detecting myocardial scar without the need of gadolinium administration desirable (7).…”

Section: Study Populationmentioning

confidence: 99%

Subacute and Chronic Left Ventricular Myocardial Scar: Accuracy of Texture Analysis on Nonenhanced Cine MR Images

et al. 2018

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Purpose To test whether texture analysis (TA) allows for the diagnosis of subacute and chronic myocardial infarction (MI) on noncontrast material-enhanced cine cardiac magnetic resonance (MR) images. Materials and Methods In this retrospective, institutional review board-approved study, 120 patients who underwent cardiac MR imaging and showed large transmural (volume of enhancement on late gadolinium enhancement [LGE] images >20%, n = 72) or small (enhanced volume 20%, n = 48) subacute or chronic ischemic scars were included. Sixty patients with normal cardiac MR imaging findings served as control subjects. Regions of interest for TA encompassing the left ventricle were drawn by two blinded, independent readers on cine images in end systole by using a freely available software package.Stepwise dimension reduction and texture feature selection based on reproducibility, machine learning, and correlation analyses were performed for selecting features, enabling the diagnosis of MI on nonenhanced cine MR images by using LGE imaging as the standard of reference. Results Five independent texture features allowed for differentiation between ischemic scar and normal myocardium on cine MR images in both subgroups: Teta1, Perc.01, Variance, WavEnHH.s-3, and S(5,5)SumEntrp (in patients with large MI: all P values < .001; in patients with small MI: Teta1 and Perc.01, P < .001; Variance, P = .026; WavEnHH.s-3, P = .007; S[5,5]SumEntrp, P = .045). Multiple logistic regression models revealed that combining the features Teta1 and Perc.01 resulted in the highest accuracy for diagnosing large and small MI on cine MR images, with an area under the curve of 0.93 and 0.92, respectively. Conclusion This proof-of-concept study indicates that TA of nonenhanced cine MR images allows for the diagnosis of subacute and chronic MI with high accuracy. (©) RSNA, 2017 Online supplemental material is available for this article. Purpose:To test whether texture analysis (TA) allows for the diagnosis of subacute and chronic myocardial infarction (MI) on noncontrast material-enhanced cine cardiac magnetic resonance (MR) images. Materials and Methods:In this retrospective, institutional review board-approved study, 120 patients who underwent cardiac MR imaging and showed large transmural (volume of enhancement on late gadolinium enhancement [LGE] images .20%, n = 72) or small (enhanced volume 20%, n = 48) subacute or chronic ischemic scars were included. Sixty patients with normal cardiac MR imaging findings served as control subjects. Regions of interest for TA encompassing the left ventricle were drawn by two blinded, independent readers on cine images in end systole by using a freely available software package. Stepwise dimension reduction and texture feature selection based on reproducibility, machine learning, and correlation analyses were performed for selecting features, enabling the diagnosis of MI on nonenhanced cine MR images by using LGE imaging as the standard of reference. Results:Five independent texture features allowed ...

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Section: Study Populationmentioning

confidence: 99%

Subacute and Chronic Left Ventricular Myocardial Scar: Accuracy of Texture Analysis on Nonenhanced Cine MR Images

et al. 2018

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“…Areas with high perfusion display contrast enhancement and have a high signal, while areas with delayed or low perfusion have a low signal and appear dark [56,57]. Sensitivity and specificity has been shown to be in the range 91-94%/ 81-88% [28].…”

Section: Diagnostic Methodsmentioning

confidence: 99%

“…Echocardiography (Echo) has the possibility to visualize global and local dysfunction as a result of ischemia but more or less requires the use of dobutamine as a stressor to avoid respiratory motion caused by exercise [26]. Myocardial perfusion single photon emission computed tomography (MPS) and CMR use vasodilators such as Adenosine and Regadenoson as pharmacological agents, if exercise is impossible [25,27,28].…”

Section: Ischemiamentioning

confidence: 99%

Magnetic Resonance Imaging of the Heart : Image quality, measurement accuracy and patient experience

Ahlander¹

2016

Linköping University Medical Dissertations

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Background: Non-invasive diagnostic imaging of atherosclerotic coronary artery disease (CAD) is frequently carried out with cardiovascular magnetic resonance imaging (CMR) or myocardial perfusion single photon emission computed tomography (MPS). CMR is the gold standard for the evaluation of scar after myocardial infarction and MPS the clinical gold standard for ischemia. Magnetic Resonance Imaging (MRI) is at times difficult for patients and may induce anxiety while patient experience of MPS is largely unknown. Aims: To evaluate image quality in CMR with respect to the sequences employed, the influence of atrial fibrillation, myocardial perfusion and the impact of patient information. Further, to study patient experience in relation to MRI with the goal of improving the care of these patients. Method: Four study designs have been used. In paper I, experimental cross-over, paper (II) experimental controlled clinical trial, paper (III) psychometric crosssectional study and paper (IV) prospective intervention study. A total of 475 patients ≥ 18 years with primarily cardiac problems (I-IV) except for those referred for MRI of the spine (III) were included in the four studies. Result: In patients (n=20) with atrial fibrillation, a single shot steady state free precession (SS-SSFP) sequence showed significantly better image quality than the standard segmented inversion recovery fast gradient echo (IR-FGRE) sequence (I). In first-pass perfusion imaging the gradient echo-echo planar imaging sequence (GREEPI) (n=30) had lower signal-to-noise and contrast–to-noise ratios than the steady state free precession sequence (SSFP) (n=30) but displayed a higher correlation with the MPS results, evaluated both qualitatively and quantitatively (II). The MRIAnxiety Questionnaire (MRI-AQ) was validated on patients, referred for MRI of either the spine (n=193) or the heart (n=54). The final instrument had 15 items divided in two factors regarding Anxiety and Relaxation. The instrument was found to have satisfactory psychometric properties (III). Patients who prior CMR viewed an information video scored significantly (lower) better in the factor Relaxation, than those who received standard information. Patients who underwent MPS scored lower on both factors, Anxiety and Relaxation. The extra video information had no effect on CMR image quality (IV). Conclusion: Single shot imaging in atrial fibrillation produced images with less artefact than a segmented sequence. In first-pass perfusion imaging, the sequence GRE-EPI was superior to SSFP. A questionnaire depicting anxiety during MRI showed that video information prior to imaging helped patients relax but did not result in an improvement in image quality

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“…PET-CT is currently considered the gold standard for noninvasive evaluation of cardiac viability [58], whereas MRI provides anatomical images with high resolution and allows accurate assessment of ventricular structure and function, as well as identification of areas with myocardial infarction [59]. Therefore, simultaneous acquisition of PET-MRI enables, for the first time, to directly compare the diagnostic performance of both modalities under the same condition, be it during rest or stress.…”

Section: Cardiovascular Applicationsmentioning

confidence: 99%

Pet-Mri

Tudisca

Nasoodi

Fraioli

2015

Nuclear Medicine Communications

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There is huge emphasis on noninvasive study of disease processes in the field of biomedical research. Combined PET-MRI allows simultaneous acquisition of physiologic information provided by PET images and morphologic and functional information obtained from MRI. The potential clinical and research applications of this technique in different organ systems and pathologies are promising (i.e. brain, cardiovascular, oncological, and inflammatory conditions). The purpose of this review is to illustrate the potential clinical advantages of this new technology, based on the authors' experience.

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Cardiovascular magnetic resonance imaging in ischemic heart disease

Cited by 33 publications

References 161 publications

Subacute and Chronic Left Ventricular Myocardial Scar: Accuracy of Texture Analysis on Nonenhanced Cine MR Images

Subacute and Chronic Left Ventricular Myocardial Scar: Accuracy of Texture Analysis on Nonenhanced Cine MR Images

Magnetic Resonance Imaging of the Heart : Image quality, measurement accuracy and patient experience

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