Image Improved Intravoxel Incoherent Motion MRI With Optimized Trigger Delays Based on Strain Curve Analysis to Evaluate Myocardial Microvascular Dysfunction of Exertional Heat Illness.
J Magn Reson Imaging
; 58(6): 1785-1796, 2023 12.
Article
en En
| MEDLINE
| ID: mdl-36943201
ABSTRACT
BACKGROUND:
Intravoxel incoherent motion (IVIM) MRI has not been widely used and its role in evaluating exertional heat illness (EHI)-related myocardial involvement remains unknown.PURPOSE:
To investigate the feasibility of strain curve-derived trigger delay (TD) IVIM-MRI and its role in assessing myocardial diffusion and microvascular perfusion of EHI patients. STUDY TYPE Prospective.SUBJECTS:
A total of 42 male EHI patients (median age 21 years) and 22 age- and sex-matched healthy controls (HC). FIELD STRENGTH/SEQUENCE A 3-T, diffusion-weighted spin-echo echo-planar-imaging sequence. ASSESSMENT IVIM-MRI was acquired by conventional TD method (group A) or strain curve-based TD method (group B) in random order. IVIM image quality was evaluated on a 3-point Likert scale (1, nondiagnostic; 2, moderate; 3, good). Technical success was defined as image quality score = 3. IVIM-MRI-derived parameters (pseudo diffusion in the capillaries [D*], perfusion fraction [f], and slow apparent diffusion coefficient [D]) were compared between EHI and HC. STATISTICAL TESTS Student's t-tests, chi-square tests, one-way analysis of variance, receiver operating characteristic (ROC) curve analysis, Pearson's correlation coefficient (r). The statistical significance level was set at P < 0.05.RESULTS:
IVIM-MRI image quality score (median [interquartile range] 3 [2, 3] vs. 2 [1-3]) and technical success rate (61.9%[13/21] vs. 28.6%[6/21]) were significantly improved in group B. EHI patients showed significantly decreased D* (118.1 ± 23.3 × 10-3 mm2 /sec vs. 142.7 ± 42.6 × 10-3 mm2 /sec) and f values (0.42 ± 0.12 vs. 0.51 ± 0.11) and significantly higher D values (3.0 ± 0.9 × 10-3 mm2 /sec vs. 2.5 ± 0.6 × 10-3 mm2 /sec) compared to HC. Relative to D and D*, f showed the most robust efficacy for detecting EHI-related myocardial injury with the highest area under the ROC curve (0.906 95% confidence interval, 0.799, 0.967) and sensitivity of 88.5% and specificity of 85.6%.CONCLUSION:
The strain curve-based TD method significantly improved image quality and technical success rate of IVIM-MRI, and f value may be an effective biomarker to assess myocardial microcirculation abnormalities of EHI patients. EVIDENCE LEVEL 2. TECHNICAL EFFICACY Stage 3.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Procesamiento de Imagen Asistido por Computador
/
Interpretación de Imagen Asistida por Computador
Tipo de estudio:
Prognostic_studies
Límite:
Adult
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Humans
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Male
Idioma:
En
Revista:
J Magn Reson Imaging
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
Año:
2023
Tipo del documento:
Article
País de afiliación:
China