Title |
Fully quantitative pixel-wise analysis of cardiovascular magnetic resonance perfusion improves discrimination of dark rim artifact from perfusion defects associated with epicardial coronary stenosis
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Published in |
Critical Reviews in Diagnostic Imaging, March 2018
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DOI | 10.1186/s12968-018-0436-0 |
Pubmed ID | |
Authors |
Allison D. Ta, Li-Yueh Hsu, Hannah M. Conn, Susanne Winkler, Anders M. Greve, Sujata M. Shanbhag, Marcus Y. Chen, W. Patricia Bandettini, Andrew E. Arai |
Abstract |
Dark rim artifacts in first-pass cardiovascular magnetic resonance (CMR) perfusion images can mimic perfusion defects and affect diagnostic accuracy for coronary artery disease (CAD). We evaluated whether quantitative myocardial blood flow (MBF) can differentiate dark rim artifacts from true perfusion defects in CMR perfusion. Regadenoson perfusion CMR was performed at 1.5 T in 76 patients. Significant CAD was defined by quantitative invasive coronary angiography (QCA) ≥ 50% diameter stenosis. Non-significant CAD (NonCAD) was defined as stenosis by QCA < 50% diameter stenosis or computed tomographic coronary angiography (CTA) < 30% in all major epicardial arteries. Dark rim artifacts had study specific and guideline-based definitions for comparison purposes. MBF was quantified at the pixel-level and sector-level. In a NonCAD subgroup with dark rim artifacts, stress MBF was lower in the subendocardial than midmyocardial and epicardial layers (2.17 ± 0.61 vs. 3.06 ± 0.75 vs. 3.24 ± 0.80 mL/min/g, both p < 0.001) and was also 30% lower than in remote regions (2.17 ± 0.61 vs. 2.83 ± 0.67 mL/min/g, p < 0.001). However, subendocardial stress MBF in dark rim artifacts was 37-56% higher than in true perfusion defects (2.17 ± 0.61 vs. 0.95 ± 0.43 mL/min/g, p < 0.001). Absolute stress MBF differentiated CAD from NonCAD with an accuracy ranging from 86 to 89% (all p < 0.001) using pixel-level analyses. Similar results were seen at a sector level. Quantitative stress MBF is lower in dark rim artifacts than remote myocardium but significantly higher than in true perfusion defects. If confirmed in larger series, this approach may aid the interpretation of clinical stress perfusion exams. ClinicalTrials.gov Identifier: NCT00027170 ; first posted 11/28/2001; updated 11/27/2017. |
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Country | Count | As % |
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United States | 4 | 31% |
Cyprus | 1 | 8% |
United Kingdom | 1 | 8% |
Spain | 1 | 8% |
Chile | 1 | 8% |
Unknown | 5 | 38% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 9 | 69% |
Scientists | 2 | 15% |
Science communicators (journalists, bloggers, editors) | 1 | 8% |
Practitioners (doctors, other healthcare professionals) | 1 | 8% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 34 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Researcher | 8 | 24% |
Student > Master | 3 | 9% |
Student > Ph. D. Student | 3 | 9% |
Other | 2 | 6% |
Lecturer | 2 | 6% |
Other | 3 | 9% |
Unknown | 13 | 38% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 9 | 26% |
Engineering | 5 | 15% |
Unspecified | 1 | 3% |
Energy | 1 | 3% |
Nursing and Health Professions | 1 | 3% |
Other | 2 | 6% |
Unknown | 15 | 44% |