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Quantification of myocardial hemorrhage using T2* cardiovascular magnetic resonance at 1.5T with ex-vivo validation.
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- Author(s): Chen, Yinyin; Ren, Daoyuan; Guan, Xingmin; Yang, Hsin-Jung; Liu, Ting; Tang, Richard; Ho, Hao; Jin, Hang; Zeng, Mengsu; Dharmakumar, Rohan
- Source:
Journal of Cardiovascular Magnetic Resonance (BioMed Central); 9/30/2021, Vol. 23 Issue 1, p1-16, 16p- Subject Terms:
MYOCARDIAL infarction diagnosis; IRON metabolism; HEMORRHAGE diagnosis; PATIENT aftercare; RESEARCH methodology; REVASCULARIZATION (Surgery); TIME; ANIMAL experimentation; MAGNETIC resonance imaging; IRON in the body; REGRESSION analysis; BODY surface mapping; COMPARATIVE studies; ELECTROPHYSIOLOGY; MASS spectrometry; ELECTROCARDIOGRAPHY; EUTHANASIA; STATISTICAL correlation; RECEIVER operating characteristic curves; LONGITUDINAL method; HEMORRHAGE - Source:
- Additional Information
- Abstract: Background: T2* cardiovascular magnetic resonance (CMR) is commonly used in the diagnosis of intramyocardial hemorrhage (IMH). For quantifying IMH with T2* CMR, despite the lack of consensus studies, two different methods [subject-specific T2* (ssT2*) and absolute T2* thresholding (aT2* < 20 ms)] are interchangeably used. We examined whether these approaches yield equivalent information. Methods: ST elevation myocardial infarction (STEMI) patients (n = 70) were prospectively recruited for CMR at 4–7 days post revascularization and for 6-month follow up (n = 43). Canines studies were performed for validation purposes, where animals (n = 20) were subject to reperfused myocardial infarction (MI) and those surviving the MI (n = 16) underwent CMR at 7 days and 8 weeks and then euthanized. Both in patients and animals, T2* of IMH and volume of IMH were determined using ssT2* and aT2* < 20 ms. In animals, ex-vivo T2* CMR and mass spectrometry for iron concentration ([Fe]
Hemo ) were determined on excised myocardial sections. T2* values based on ssT2* and absolute T2* threshold approaches were independently regressed against [Fe]Hemo and compared. A range of T2* cut-offs were tested to determine the optimized conditions relative to ssT2*. Results: While both approaches showed many similarities, there were also differences. Compared to ssT2*, aT2* < 20 ms showed lower T2* and volume of IMH in patients and animals independent of MI age (all p < 0.005). While T2* determined from both methods were highly correlated against [Fe]Hemo (R2 = 0.9 for both), the slope of the regression curve for ssT2* was significantly larger as compared to aT2* < 20 ms (0.46 vs. 0.32, p < 0.01). Further, slightly larger absolute T2* cut-offs (patients: 23 ms; animals: 25 ms) showed similar IMH characteristics compared to ssT2*. Conclusion: Current quantification methods have excellent capacity to identify IMH, albeit the T2*of IMH and volume of IMH based on aT2* < 20 ms are smaller compared to ssT2*. Thus the method used to quantify IMH from T2* CMR may influence the diagnosis for IMH. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of Journal of Cardiovascular Magnetic Resonance (BioMed Central) is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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