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Validation of contrast enhanced cine steady-state free precession and T2-weighted CMR for assessment of ischemic myocardial area-at-risk in the presence of reperfusion injury

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Validation of contrast enhanced cine steady-state free precession and T2-weighted CMR for assessment of ischemic myocardial area-at-risk in the presence of reperfusion injury. / Hansen, Esben Søvsø Szocska; Pedersen, Steen Fjord; Pedersen, Steen Bønløkke; Bøtker, Hans Erik; Kim, Won Yong.

In: The international journal of cardiovascular imaging, Vol. 35, No. 6, 06.2019, p. 1039–1045.

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@article{6bdc1d38b7d14c41b964b00c79f14b3f,
title = "Validation of contrast enhanced cine steady-state free precession and T2-weighted CMR for assessment of ischemic myocardial area-at-risk in the presence of reperfusion injury",
abstract = "The purpose of the study was to validate by histopathology, contrast enhanced cine steady-state free precession and T2-weighted CMR for the assessment of ischemic myocardial area-at-risk (AAR) in the presence of microvascular obstruction (MVO). Eleven anesthetized pigs underwent CMR 7 to 10 days post infarction. The area-at-risk was measured from T2-weighted fast spin echo (T2-STIR) and contrast-enhanced steady-state free precession magnetic resonance imaging (CE-SSFP) images using semi-automated algorithms based on a priori knowledge of perfusion territory. Also, late gadolinium enhancement (LGE) was performed to measure final infarct size (FIS). Histopathological comparison with Evans blue dye to define AAR and triphenyltetrazolium chloride to define FIS served as the reference. All infarcts demonstrated MVO on LGE images. Bland-Altman analysis showed no significant bias in AAR or myocardial salvage between T2-STIR and CE-SSFP or between CMR and histopathology. The mean differences ± 2SD from Bland-Altman analysis were: AAR: Evans Blue vs. T2-STIR [0.7%; + 13.5%; - 12.1%]; AAR: Evans Blue vs. CE-SSFP [0.1%; + 13.8%; - 13.7%]; AAR: T2-STIR vs. CE-SSFP [0.7%; + 6.2%; - 4.9%]; Salvage: Evans Blue - TTC vs. T2-STIR-LGE [0.8%; + 11.1%; - 9.6%]; Salvage: Evans Blue - TTC vs. CE-SSFP-LGE [0.1%; + 9.9%; - 9.6%]; Salvage: CE-SSFP-LGE vs. T2-STIR-LGE [0.7%; + 6.2%; - 4.9%]. Both T2-STIR and CE-SSFP sequences allow for unbiased quantification of AAR in the presence of ischemia/reperfusion injury when analysed by semi-automated algorithms. These experimental data, which was validated by histopathology, supports the use of CMR for the assessment of myocardial salvage during the subacute phase.",
keywords = "Edema, Final infarct size, Magnetic resonance imaging, Myocardium at risk, Salvage, INFARCTION, EDEMA, QUANTIFICATION, Predictive Value of Tests, Reproducibility of Results, Image Interpretation, Computer-Assisted, Myocardial Infarction/diagnostic imaging, Magnetic Resonance Imaging, Cine/methods, Animals, Myocardium/pathology, Female, Organometallic Compounds/administration & dosage, Tissue Survival, Contrast Media/administration & dosage, Myocardial Reperfusion Injury/diagnostic imaging, Sus scrofa, Observer Variation, Disease Models, Animal",
author = "Hansen, {Esben S{\o}vs{\o} Szocska} and Pedersen, {Steen Fjord} and Pedersen, {Steen B{\o}nl{\o}kke} and B{\o}tker, {Hans Erik} and Kim, {Won Yong}",
year = "2019",
month = jun,
doi = "10.1007/s10554-019-01569-x",
language = "English",
volume = "35",
pages = "1039–1045",
journal = "International Journal of Cardiovascular Imaging",
issn = "1569-5794",
publisher = "Springer",
number = "6",

}

RIS

TY - JOUR

T1 - Validation of contrast enhanced cine steady-state free precession and T2-weighted CMR for assessment of ischemic myocardial area-at-risk in the presence of reperfusion injury

AU - Hansen, Esben Søvsø Szocska

AU - Pedersen, Steen Fjord

AU - Pedersen, Steen Bønløkke

AU - Bøtker, Hans Erik

AU - Kim, Won Yong

PY - 2019/6

Y1 - 2019/6

N2 - The purpose of the study was to validate by histopathology, contrast enhanced cine steady-state free precession and T2-weighted CMR for the assessment of ischemic myocardial area-at-risk (AAR) in the presence of microvascular obstruction (MVO). Eleven anesthetized pigs underwent CMR 7 to 10 days post infarction. The area-at-risk was measured from T2-weighted fast spin echo (T2-STIR) and contrast-enhanced steady-state free precession magnetic resonance imaging (CE-SSFP) images using semi-automated algorithms based on a priori knowledge of perfusion territory. Also, late gadolinium enhancement (LGE) was performed to measure final infarct size (FIS). Histopathological comparison with Evans blue dye to define AAR and triphenyltetrazolium chloride to define FIS served as the reference. All infarcts demonstrated MVO on LGE images. Bland-Altman analysis showed no significant bias in AAR or myocardial salvage between T2-STIR and CE-SSFP or between CMR and histopathology. The mean differences ± 2SD from Bland-Altman analysis were: AAR: Evans Blue vs. T2-STIR [0.7%; + 13.5%; - 12.1%]; AAR: Evans Blue vs. CE-SSFP [0.1%; + 13.8%; - 13.7%]; AAR: T2-STIR vs. CE-SSFP [0.7%; + 6.2%; - 4.9%]; Salvage: Evans Blue - TTC vs. T2-STIR-LGE [0.8%; + 11.1%; - 9.6%]; Salvage: Evans Blue - TTC vs. CE-SSFP-LGE [0.1%; + 9.9%; - 9.6%]; Salvage: CE-SSFP-LGE vs. T2-STIR-LGE [0.7%; + 6.2%; - 4.9%]. Both T2-STIR and CE-SSFP sequences allow for unbiased quantification of AAR in the presence of ischemia/reperfusion injury when analysed by semi-automated algorithms. These experimental data, which was validated by histopathology, supports the use of CMR for the assessment of myocardial salvage during the subacute phase.

AB - The purpose of the study was to validate by histopathology, contrast enhanced cine steady-state free precession and T2-weighted CMR for the assessment of ischemic myocardial area-at-risk (AAR) in the presence of microvascular obstruction (MVO). Eleven anesthetized pigs underwent CMR 7 to 10 days post infarction. The area-at-risk was measured from T2-weighted fast spin echo (T2-STIR) and contrast-enhanced steady-state free precession magnetic resonance imaging (CE-SSFP) images using semi-automated algorithms based on a priori knowledge of perfusion territory. Also, late gadolinium enhancement (LGE) was performed to measure final infarct size (FIS). Histopathological comparison with Evans blue dye to define AAR and triphenyltetrazolium chloride to define FIS served as the reference. All infarcts demonstrated MVO on LGE images. Bland-Altman analysis showed no significant bias in AAR or myocardial salvage between T2-STIR and CE-SSFP or between CMR and histopathology. The mean differences ± 2SD from Bland-Altman analysis were: AAR: Evans Blue vs. T2-STIR [0.7%; + 13.5%; - 12.1%]; AAR: Evans Blue vs. CE-SSFP [0.1%; + 13.8%; - 13.7%]; AAR: T2-STIR vs. CE-SSFP [0.7%; + 6.2%; - 4.9%]; Salvage: Evans Blue - TTC vs. T2-STIR-LGE [0.8%; + 11.1%; - 9.6%]; Salvage: Evans Blue - TTC vs. CE-SSFP-LGE [0.1%; + 9.9%; - 9.6%]; Salvage: CE-SSFP-LGE vs. T2-STIR-LGE [0.7%; + 6.2%; - 4.9%]. Both T2-STIR and CE-SSFP sequences allow for unbiased quantification of AAR in the presence of ischemia/reperfusion injury when analysed by semi-automated algorithms. These experimental data, which was validated by histopathology, supports the use of CMR for the assessment of myocardial salvage during the subacute phase.

KW - Edema

KW - Final infarct size

KW - Magnetic resonance imaging

KW - Myocardium at risk

KW - Salvage

KW - INFARCTION

KW - EDEMA

KW - QUANTIFICATION

KW - Predictive Value of Tests

KW - Reproducibility of Results

KW - Image Interpretation, Computer-Assisted

KW - Myocardial Infarction/diagnostic imaging

KW - Magnetic Resonance Imaging, Cine/methods

KW - Animals

KW - Myocardium/pathology

KW - Female

KW - Organometallic Compounds/administration & dosage

KW - Tissue Survival

KW - Contrast Media/administration & dosage

KW - Myocardial Reperfusion Injury/diagnostic imaging

KW - Sus scrofa

KW - Observer Variation

KW - Disease Models, Animal

UR - http://www.scopus.com/inward/record.url?scp=85062681808&partnerID=8YFLogxK

U2 - 10.1007/s10554-019-01569-x

DO - 10.1007/s10554-019-01569-x

M3 - Journal article

C2 - 30852704

VL - 35

SP - 1039

EP - 1045

JO - International Journal of Cardiovascular Imaging

JF - International Journal of Cardiovascular Imaging

SN - 1569-5794

IS - 6

ER -