| ǥ :
|
ȣ - 540825 236 |
| Clinical Impacts of Brightness on Cardiac Magnetic Resonance
In Various Cardiac Diseases
|
| 가톨릭 의과대학 순환기 내과¹ ,영상진단의학과² |
| 김지희¹, 윤호중¹ ,정정임² ,서석민¹ ,엄재선¹ ,박훈준¹ ,김범준¹ ,정해억¹ ,장기육¹ ,오용석¹ ,정욱성¹ ,승기배¹ |
Objective: Cardiac Magnetic resonance (CMR) imaging, especially when used with late gadolinium enhancement (LGE), is a highly sensitive non-invasive imaging technique for detecting myocardial abnormalities. However, clinical impacts of LGE in ischemic and non-ischemic heart disease are controversial.
Methods: In a retrospective database search, 225 subjects (M:F = 142:83; mean age, 55 ± 16 years) with various heart diseases who exhibited LGE on CMR were identified at our institution. In total, 225 patients underwent further evaluations (i.e ECG, biomarker, echocardiography, coronary angiography, myocardial biopsy if needed) for diagnosis and treatment. Types of LGE are divided into 5 categories as follows; subendocardial (SE-LGE); transmural (T-LGE); subepicardial (SP-LGE); midwall (M-LGE); multiple patchy (P-LGE).
Results: 1) In ischemic heart disease, SE-LGE or T-LGE pattern was present in 92/117 patients (78%); 34/37 patients (92%) with STEMI, and 41/52 patients (79%) with old myocardial infarction (MI). 2) Typical LGE patterns such as SP-LGE, M-LGE and P-LGE showed only in 21/70 patients (30%) with dilated cardiomyopathy, myocarditis, hypertrophic cardiomyopathy, and infiltrative disease. 3) 38 patients with stress-induced CMP, tachycardia-induced CMP, variant angina, arrhythmia, chemotherapy-induced CMP and hemochromatosis did not present any typical LGE patterns in CMR images.
Conclusions: Typical LGE patterns in subjects with MI are frequently observed and give us valuable informations about the viable myocardium. But typical LGE patterns in non-ischemic cardiomyopathy might be less informative because these are infrequently observed.
Key words: late gadolinium enhancement, cardiac magnetic resonance, heart disease
|
|
Table 1. Various LGE patterns for clinically ischemic and non-ischemic heart disease
|
|
No LGE |
SE-LGE |
T-LGE |
SP-LGE |
M-LGE |
P-LGE |
Total |
|
STEMI |
3 |
9 |
25 |
0 |
0 |
0 |
37 |
|
NSTEMI |
1 |
2 |
3 |
0 |
0 |
1 |
7 |
|
UA |
6 |
2 |
9 |
0 |
0 |
0 |
17 |
|
Old MI |
8 |
10 |
31 |
0 |
3 |
0 |
52 |
|
SA |
3 |
0 |
1 |
0 |
0 |
0 |
4 |
|
DCMP |
25 |
0 |
0 |
0 |
1 |
4 |
30 |
|
Myocarditis |
9 |
0 |
3 |
9 |
0 |
3 |
24 |
|
HCMP |
8 |
0 |
0 |
1 |
1 |
0 |
10 |
|
ID |
3 |
1 |
0 |
0 |
0 |
2 |
6 |
|
Others |
38 |
0 |
0 |
0 |
0 |
0 |
38 |
|
Total |
104 |
24 |
72 |
10 |
5 |
10 |
225 |
LGE: late gadolinium enhancement, SE-LGE: subendocardium LGE, T-LGE: transmural LGE, SP-LGE: subepicardial LGE, M-LGE: midwall LGE, P-LGE: multiple patchy LGE, STEMI: ST-elevation myocardial infarction, NSTEMI: non ST-elevation myocardial infarction, UA: unstable angina, SA: stable angina, DCMP: dilated cardiomyopathy, HCMP: hypertrophic cardiomyopathy, ID: infiltrative disease
|
|
|
