The impact of dark-blood versus conventional bright-blood late gadolinium enhancement on the myocardial ischemic burden

Franks, Russell; Holtackers, Robert J.; Alskaf, Ebraham; Nazir, Muhummad Sohaib; Clapp, Brian; Wildberger, Joachim E.; Perera, Divaka; Plein, Sven; Chiribiri, Amedeo

doi:10.1016/j.ejrad.2021.109947

Cited by 1 publication

(2 citation statements)

References 26 publications

(41 reference statements)

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“…Thirty-four patients who underwent stress perfusion CMR scans, 28 of which have been previously reported 24 as having visually apparent stress perfusion defects and 6 patients with visually normal perfusion, were retrospectively identified. All patients gave written informed consent (regional ethics committees: 15/NS/0030 and 18/ES/0115), and patients were instructed to refrain from caffeine for 24 h prior to the CMR examination.…”

Section: Methodsmentioning

confidence: 99%

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High-resolution quantification of stress perfusion defects by cardiac magnetic resonance

Scannell,

Crawley,

Alskaf

et al. 2024

European Heart Journal - Imaging Methods and Practice

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Aims Quantitative stress perfusion cardiac magnetic resonance (CMR) is becoming more widely available, but it is still unclear how to integrate this information in clinical decision making. Typically, pixel-wise perfusion maps are generated but diagnostic and prognostic studies have summarised perfusion as just one value per-patient or in 16 myocardial segments. In this study, the reporting of quantitative perfusion maps is extended from the standard 16 segments to a high-resolution bullseye. Cut-off thresholds are established for the high-resolution bullseye and the identified perfusion defects are compared versus visual assessment. Methods and results 34 patients with known or suspected coronary artery disease were retrospectively analysed. Visual perfusion defects were contoured on the CMR images and pixel-wise quantitative perfusion maps were generated. Cut-off values were established on the high-resolution bullseye consisting of 1800 points and compared to the per-segment, per-coronary, and per-patient resolution thresholds. Quantitative stress perfusion was significantly lower in visually abnormal pixels 1.11 (0.75-1.57) versus 2.35 (1.82-2.9) ml/min/g (Mann-Whitney U test p < 0.001), with an optimal cut-off of 1.72 ml/min/g. This was lower than the segment-wise optimal threshold of 1.92 ml/min/g. Bland-Altman analysis showed visual assessment underestimated large perfusion defects compared to the quantification with good agreement for smaller defect burdens. A Dice overlap of 0.68 (0.57-0.78) was found. Conclusions This study introduces a high-resolution bullseye consisting of 1800 points, rather than 16, per patient for reporting quantitative stress perfusion which may improve sensitivity. Using this representation, the threshold required to identify areas of reduced perfusion is lower than for segmental analysis.

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Section: Methodsmentioning

confidence: 99%

“…The analysis was performed jointly by two experienced operators. 24 The rest of the images were not analysed and the presence or absence of LGE was not considered.…”

Section: Methodsmentioning

confidence: 99%