Late gadolinium-enhanced cardiovascular MRI at end-systole: feasibility study.
OBJECTIVE
The purpose of this article is to evaluate the image quality and infarct size of segmented late gadolinium-enhanced cardiovascular MRI at end-systole, compared with middiastole, in patients with sinus rhythm (SR) and to compare the image quality of end-systole images in patients with atrial fibrillation (AFib) to that of end-systole and middiastole images in patients with SR.


METHODS
Study patients (n = 121) were distributed according to heart rate and rhythm: SR with low heart rate (≤ 65 beats/minute), SR with intermediate heart rate (66-75 beats/minute), SR with high heart rate (≥ 76 beats/minute), and AFib. Image quality was graded on a 5-point scale, where 4 equals optimal and 0 equals not assessable. Global infarct size (percentage of left ventricle [LV] myocardium) in patients with SR with myocardial infarction was quantified using a visual quantitative approach with a 5-point scale and a semiautomatic method.


RESULTS
End-systole imaging had higher image quality than did middiastole imaging for patients with SR with high heart rate, whereas middiastole imaging had higher image quality than did end-systole imaging for patients with SR with low heart rate (p < 0.05 for patients with SR with low heart rate, p = 0.60 for patients with SR with intermediate heart rate, and p = 0.001 for patients with SR with high heart rate). The quality of end-systole imaging in patients with AFib was not significantly different from that in patients with SR (p = 0.40 vs SR middiastole imaging and p = 0.38 vs SR end-systole imaging). The average difference of global infarct size was -0.3% and 0.2% of LV myocardium, and the limits of agreement were ± 2.4% and ± 3.3% of LV myocardium, for visual assessment and semiautomatic assessment, respectively.


CONCLUSIONS
End-systole imaging can provide accurate diagnosis of myocardial infarction, comparable to middiastole imaging. The image quality of end-systole imaging is less susceptible to heart rate and rhythm compared with middiastole imaging.
Cardiovascular Center, Rakuwakai Otowa Hospital, Yamashina-ku, Kyoto, Japan. matsumoto.hidenari@gmail.com
Hidenari
H
Matsumoto
Tetsuya
T
Matsuda
Kenichi
K
Miyamoto
Toshihiko
T
Shimada
Atsushi
A
Hayashi
Mikiko
M
Mikuri
Yuji
Y
Hiraoka
D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003971:Diastole; D005240:Feasibility Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D009942:Organometallic Compounds; D011859:Radiography; D018709:Statistics, Nonparametric; D013599:Systole
D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine