Objective: To determine long term reproducibility of the late enhancement(LE) signal in contrast enhanced magnetic resonance imaging(MRI) and potential changes of the signal after revascularisation. Methods: 33 patien...Objective: To determine long term reproducibility of the late enhancement(LE) signal in contrast enhanced magnetic resonance imaging(MRI) and potential changes of the signal after revascularisation. Methods: 33 patients(29 men, mean(SD)61(11) years) with coronary artery disease(CAD) and left ventricular dysfunction(ejection fraction 30(7)%) underwent two contrast enhanced MRI procedures within 9(3) months. Fifteen patients(group A: 14 men, 59(12) years) had no interventions between the two studies. Eighteen patients underwent revascularisation after MRI 1(group B: 15 men, 62(9) years). Changes in the LE signal between the first and second MRIs were investigated in both groups as well as intraobserver and interobserver variabilities for delineation of the signal. Results: The LE signal was highly reproducible in groups A and B for segmental analysis(concordance 86%v 82%, respectively; κ=0.70 v 0.67) and summed scores(group A: r=0.97, p< 0.001; group B: r=0.93, p< 0.001). The LE signal was quantified as 27(27) cm3 in group A versus 30(16) cm3 in group B in the first MRI and 26(25) cm3 versus 30(15) cm3, respectively, for the second MRI(both not significant). Moreover, low intraobserver and interobserver variabilities were observed in segmental analysis(κ=0.86 and 0.74, respectively, for group A, and κ=0.87 and 0.82, respectively, for group B). Conclusion: In patients with chronic CAD, the LE signal in contrast enhanced MRI is very stable over an extended time period. These results further characterise contrast enhanced MRI as a useful tool for myocardial viability assessment. Low intraobserver and interobserver variabilities promise robustness of the method for clinical application.展开更多
文摘Objective: To determine long term reproducibility of the late enhancement(LE) signal in contrast enhanced magnetic resonance imaging(MRI) and potential changes of the signal after revascularisation. Methods: 33 patients(29 men, mean(SD)61(11) years) with coronary artery disease(CAD) and left ventricular dysfunction(ejection fraction 30(7)%) underwent two contrast enhanced MRI procedures within 9(3) months. Fifteen patients(group A: 14 men, 59(12) years) had no interventions between the two studies. Eighteen patients underwent revascularisation after MRI 1(group B: 15 men, 62(9) years). Changes in the LE signal between the first and second MRIs were investigated in both groups as well as intraobserver and interobserver variabilities for delineation of the signal. Results: The LE signal was highly reproducible in groups A and B for segmental analysis(concordance 86%v 82%, respectively; κ=0.70 v 0.67) and summed scores(group A: r=0.97, p< 0.001; group B: r=0.93, p< 0.001). The LE signal was quantified as 27(27) cm3 in group A versus 30(16) cm3 in group B in the first MRI and 26(25) cm3 versus 30(15) cm3, respectively, for the second MRI(both not significant). Moreover, low intraobserver and interobserver variabilities were observed in segmental analysis(κ=0.86 and 0.74, respectively, for group A, and κ=0.87 and 0.82, respectively, for group B). Conclusion: In patients with chronic CAD, the LE signal in contrast enhanced MRI is very stable over an extended time period. These results further characterise contrast enhanced MRI as a useful tool for myocardial viability assessment. Low intraobserver and interobserver variabilities promise robustness of the method for clinical application.
