title: Myocardial extracellular volume fraction measurement in chronic total coronary occlusion: Association with myocardial injury, angiographic collateral flow, and functional recovery.
abstract: To investigate whether myocardial extracellular volume fraction (ECV) measurement by cardiac MR is indicative of myocardial injury, angiographic collateral flow, and functional recovery in patients with chronic total coronary occlusion (CTO).
  
  
  
  A total of 50 CTO patients undergoing 1.5 Tesla MR were prospectively enrolled, and 28 underwent a second MR 6 months after revascularization. T1-mapping based indices, including pre- and postcontrast T1 values and ECV, were obtained from infarcted and non-infarcted myocardium, myocardial segments, and coronary territory. The severity of myocardial injury was rated by transmurality extent of infarction (TEI) and regional wall motion abnormalities (RWMA) score. Angiographic collateral flow was evaluated using Rentrop classification. Improvement in segmental wall motion at 6 months was also assessed.
  
  
  
  ECV and postcontrast T1 value significantly outperformed precontrast T1 value for identifying myocardial infarction (area under the receiver operating characteristic curve [AUC]: 0.998 and 0.953 versus 0.824, all P < 0.02). Myocardial ECV was strongly correlated with TEI (P = 0.000), RWMA score (P = 0.000), and collateral classification (P = 0.007 for left anterior descending artery [LAD] territory, P = 0.001 for non-LAD territory). Furthermore, the likelihood of functional recovery was better predicted by ECV than by late gadolinium enhancement (LGE) (AUC: 0.76 versus 0.68, P < 0.02).
  
  
  
  Myocardial ECV may be a useful surrogate to assess myocardial injury and angiographic collateral flow in CTO, and ECV provides incremental value to LGE in assessing functional recovery after revascularization. J. MAGN. RESON. IMAGING 2016;44:972-982.
authors.affiliation: Department of Radiology, Zhongshan Hospital, Fudan University, Department of Medical Imaging, Shanghai Medical school, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Yin-Yin
authors.initials: YY
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
authors.forename: Dao-Yuan
authors.initials: DY
authors.lastname: Ren
authors.affiliation: Department of Radiology, Zhongshan Hospital, Fudan University, Department of Medical Imaging, Shanghai Medical school, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Meng-Su
authors.initials: MS
authors.lastname: Zeng
authors.affiliation: Department of Radiology, Zhongshan Hospital, Fudan University, Department of Medical Imaging, Shanghai Medical school, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Shan
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Radiology, Zhongshan Hospital, Fudan University, Department of Medical Imaging, Shanghai Medical school, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yun
authors.affiliation: Siemens Shenzhen Magnetic Resonance, Shenzhen, China.
authors.forename: Cai-Xia
authors.initials: CX
authors.lastname: Fu
authors.affiliation: Department of Cardiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
authors.forename: Jun-Bo
authors.initials: JB
authors.lastname: Ge
authors.affiliation: Department of Radiology, Zhongshan Hospital, Fudan University, Department of Medical Imaging, Shanghai Medical school, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China. jin.hang@outlook.com.
authors.forename: Hang
authors.initials: H
authors.lastname: Jin
authors.affiliation: Department of Cardiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
authors.forename: Ju-Ying
authors.initials: JY
authors.lastname: Qian
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
authors.forename: Wei-Guo
authors.initials: WG
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D057791:Cardiac Imaging Techniques / Q000379:methods; D003326:Coronary Circulation; D054059:Coronary Occlusion / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D045604:Extracellular Fluid / Q000000981:diagnostic imaging*; D005260:Female; D006335:Heart Injuries / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: T1-mapping; cardiac; chronic total coronary occlusion; extracellular volume fraction; magnetic resonance imaging