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Quantification of perfusion defects with high resolution 2D and 3D adenosine stress perfusion 3.0 Tesla CMR

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Myocardial ischaemic burden is an important marker of outcome in stable ischaemic heart disease with a 10% ischaemic burden suggested as a clinically relevant threshold for revascularisation... Standard CMR stress perfusion imaging utilises 3 short axis slices, each acquired in different phases of the cardiac cycle... Recently proposed 3D myocardial perfusion CMR allows the entire myocardium to be sampled within the same cardiac phase and therefore should allow more accurate quantification of ischaemic burden without extrapolation... In this study we compared visual ischaemia detection and quantification by 2D high resolution and 3D whole heart myocardial perfusion CMR... CMR imaging was performed on a 3T Philips Achieva TX system... Perfusion images were analysed independently by two observers... Image quality (4 = Excellent, 3 = Good, 2 = Poor, 1 = uninterpretable) and diagnostic confidence by coronary territory was graded (1 = high diagnostic confidence, 0 = low diagnostic confidence)... Perfusion abnormalities were contoured in the frame of maximal remote myocardium signal intensity, and expressed as a percentage of total myocardium... Of the 23 paired data sets, images in one 2D set were uninterpretable due to artefact, leaving 22 pairs for analysis... Image quality was excellent or good in 21/22(95%) for 2D and 20/22(91%) for 3D acquisitions... At the 10% threshold of ischaemic burden with either method, there was agreement in 9 of 12 sets, in non-agreement 2D quantification was greater than 3D and differed by 1.1, 3.2, and 10.9%... Image quality and diagnostic confidence are similar with both high resolution 2D and whole heart 3D myocardial perfusion CMR.

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Diagnostic Confidence by Coronary Territory.
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Figure 1: Diagnostic Confidence by Coronary Territory.

Mentions: Of the 23 paired data sets, images in one 2D set were uninterpretable due to artefact, leaving 22 pairs for analysis. Image quality was excellent or good in 21/22(95%) for 2D and 20/22(91%) for 3D acquisitions. Diagnostic confidence expressed by coronary territory did not differ significantly in LAD, LCx or RCA [Figure 1] (p = 0.12, 1.0 and 0.74 respectively). 2D and 3D perfusion quantification agreed, with a mean bias on Bland Altman analysis of 0.7%(r2 = 0.488, p < 0.001) [Figure 2]. At the 10% threshold of ischaemic burden with either method, there was agreement in 9 of 12 sets, in non-agreement 2D quantification was greater than 3D and differed by 1.1, 3.2, and 10.9%.


Quantification of perfusion defects with high resolution 2D and 3D adenosine stress perfusion 3.0 Tesla CMR
Diagnostic Confidence by Coronary Territory.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4043826&req=5

Figure 1: Diagnostic Confidence by Coronary Territory.
Mentions: Of the 23 paired data sets, images in one 2D set were uninterpretable due to artefact, leaving 22 pairs for analysis. Image quality was excellent or good in 21/22(95%) for 2D and 20/22(91%) for 3D acquisitions. Diagnostic confidence expressed by coronary territory did not differ significantly in LAD, LCx or RCA [Figure 1] (p = 0.12, 1.0 and 0.74 respectively). 2D and 3D perfusion quantification agreed, with a mean bias on Bland Altman analysis of 0.7%(r2 = 0.488, p < 0.001) [Figure 2]. At the 10% threshold of ischaemic burden with either method, there was agreement in 9 of 12 sets, in non-agreement 2D quantification was greater than 3D and differed by 1.1, 3.2, and 10.9%.

View Article: PubMed Central - HTML

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Myocardial ischaemic burden is an important marker of outcome in stable ischaemic heart disease with a 10% ischaemic burden suggested as a clinically relevant threshold for revascularisation... Standard CMR stress perfusion imaging utilises 3 short axis slices, each acquired in different phases of the cardiac cycle... Recently proposed 3D myocardial perfusion CMR allows the entire myocardium to be sampled within the same cardiac phase and therefore should allow more accurate quantification of ischaemic burden without extrapolation... In this study we compared visual ischaemia detection and quantification by 2D high resolution and 3D whole heart myocardial perfusion CMR... CMR imaging was performed on a 3T Philips Achieva TX system... Perfusion images were analysed independently by two observers... Image quality (4 = Excellent, 3 = Good, 2 = Poor, 1 = uninterpretable) and diagnostic confidence by coronary territory was graded (1 = high diagnostic confidence, 0 = low diagnostic confidence)... Perfusion abnormalities were contoured in the frame of maximal remote myocardium signal intensity, and expressed as a percentage of total myocardium... Of the 23 paired data sets, images in one 2D set were uninterpretable due to artefact, leaving 22 pairs for analysis... Image quality was excellent or good in 21/22(95%) for 2D and 20/22(91%) for 3D acquisitions... At the 10% threshold of ischaemic burden with either method, there was agreement in 9 of 12 sets, in non-agreement 2D quantification was greater than 3D and differed by 1.1, 3.2, and 10.9%... Image quality and diagnostic confidence are similar with both high resolution 2D and whole heart 3D myocardial perfusion CMR.

No MeSH data available.