Keywords:
Cardiac, MR physics, Contrast agents, MR, Imaging sequences, Cardiac Assist Devices, Artifacts
Authors:
B. Fraj1, M. Attia2, S. BEN MARZOUK1, A. chalbia3, I. Baccouche1, M. Affes1, H. Neji1, S. Hantous-Zannad1, K. Ben Miled1; 1TUNIS/TN, 2ARIANA/TN, 3La Marsa/TN
DOI:
10.26044/ecr2019/C-3493
Methods and materials
1.
Population
- We reviewed 80 consecutive patients (53 male and 27 female patients; age range: 25–82 years; mean age:58.6 years) who underwent cardiac MRI with late gadolinium enhancement(LGE) sequences including both breath-held 2D PSIR and breath-held 2D IR sequences ,
from January 2016 through January 2018.
2.
Etiologies:
- We included patients who underwent LGE–MRI due to hypertrophic cardiomyopathy(n=19),
dilated cardiomyopathy (n=10),
sarcoidosis (n=8),
amyloidosis (n=10),
non compaction of left ventricular (n=3) and myocarditis (n=30) on the basis of clinical,
laboratory,
electrocardiographic,
echocardiographic criteria.
3.
Protocol:
- All studies were performed on a clinical 1.5 Tesla MR scanner Philips Ingenia equipped with a dedicated cardiac software package and a 8-element cardiac phased-array coil.
- In all cases,
double oblique long-axis scouts were taken to obtain true short-axis and long-axis references.
Cine images were acquired in short-axis views and long-axis views.
Five to ten minutes after the injection of 0.2 mmol/kg Gadolinium,
we acquired 2D IR sequences that spanned the left ventricle from the base to the apex,
selecting the myocardium null TI values from TI scouts.
- The breath-held 2D PSIR images were obtained directly after the breath-held 2D IR sequence,
which was used as a reference for comparison with the 2D PSIR technique.
4.
Qualitative evaluation :
- All short-axial LGE images were evaluated independently by two cardiovascular radiologists with five and one year of experience.
- All LGE-positive patients were qualitatively assessed using a 3-point scale (poor,
fair,
good) evaluating overall image quality ,
quality of contract and presence of artifacts.
- We also evaluate the quality of LGE of the right ventricle and the visibility of thrombi.
- The average number of enhanced segments,
the location of LGE in the basal,
mid and apical area of the left ventricle and its myocardial distribution in subendocardial,
subepicardial,
midwal and patchy respectively were also noted based on the Bullseye of AHA 17-segment model.
|
Overall image quality |
Quality of contrast |
Artifacts |
Visibility of the LGE right ventricle |
Visibility of thrombi |
1 |
Poor |
Poor |
Few |
Poor |
Poor |
2 |
Acceptable |
Acceptable |
Moderate |
Acceptable |
Acceptable |
3 |
Good |
Good |
A lot |
Good |
Good |
Table 1 : Qualitative 3-level scale
5.
Statistical analysis :
- The data was captured and analyzed using SPSS software version 24.0 for Windows.
- The descriptive study consisted of a calculation of frequencies,
percentages and averages.
- For the Analytical Study we used the appropriate tests for the comparison of qualitative,
quantitative and average variables.
- For the study of the concordance between the two techniques,
we used the Kappa test.
- A p<0.05 was considered significant .