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Rapid and accurate determination of relative infarct size in humans using contrast-enhanced magnetic resonance imaging

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Abstract

Background

In clinical routine, rapid infarct sizing techniques are warranted, as objective and precise infarct sizing is important for clinical decision-making. Accurate and objective measures of relative infarct size (rIS) using contrast-enhanced cardiac magnetic resonance (ceCMR) have been extensively demonstrated in experimental animals, but less in humans. The aim of this study was therefore to quantify rIS assessed by ceCMR in patients with chronic myocardial infarction using semi-automatic quantitation techniques.

Methods

A total of 62 patients (mean age 66 ± 9 years) with ischemic cardiomyopathy (EF 24 ± 8%) underwent ceCMR for viability testing. rIS was obtained by two time-saving semi-automatic thresholding methods based on: (1) visual definition of a single signal intensity cutoff value (VISUAL) and (2) the full-width-at-half-maximum technique (FWHM). Results were compared to manual tracing (MANUAL) as the reference standard.

Results

VISUAL showed better agreement [r = 0.99; intraclass correlation coefficient (ICC) = 0.98, limits of agreement ±3.2%] to MANUAL than the FWHM technique (r = 0.77, ICC = 0.76, limits of agreement ±12%). Infarct sizing using MANUAL was twice as time-consuming (3.1 ± 0.2 min) compared to VISUAL (1.6 ± 0.1 min) or FWHM (1.6 ± 0.2 min).

Conclusions

Visual estimation of signal intensity cutoff values allows rapid and accurate determination of rIS in patients with chronic myocardial infarction using ceCMR and is superior to the FWHM technique.

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Authors and Affiliations

  1. Medical Clinic I, University Hospital of the RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany

    Mirja Neizel, Elisabeth Schade, Tienush Rassaf, Malte Kelm & Harald P. Kühl

  2. Department of Radiology, University Hospital of the RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany

    Marcus Katoh & Gabriele A. Krombach

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  1. Mirja Neizel
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  2. Marcus Katoh
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  3. Elisabeth Schade
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  4. Tienush Rassaf
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  5. Gabriele A. Krombach
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  6. Malte Kelm
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  7. Harald P. Kühl
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Correspondence to Mirja Neizel.

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Neizel, M., Katoh, M., Schade, E. et al. Rapid and accurate determination of relative infarct size in humans using contrast-enhanced magnetic resonance imaging. Clin Res Cardiol 98, 319–324 (2009). https://doi.org/10.1007/s00392-009-0007-3

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  • DOI: https://doi.org/10.1007/s00392-009-0007-3

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