Quantitative comparison of 2D and 3D late gadolinium enhancement MR imaging for cardiomyopathies
KeywordsLate Gadolinium Enhancement Fabry Disease Myocardial Mass Subjective Image Quality Late Gadolinium Enhancement Imaging
LGE is widely used as a means to quantify scar or fibrotic tissue in patients suffering from cardiomyopathies. In clinical routine 2D data acquisition is most commonly practiced, albeit having the drawback of multiple breath-holds and long acquisition times. 3D acquisition can significantly reduce acquisition time. This leads to shortened scan time and a more efficient use of available MRI resources. So our purpose was to determine whether the quantification of myocardial fibrosis in patients with Fabry disease and hypertrophic cardiomyopathy (HCM) using a late gadolinium enhancement (LGE) single-breath-hold three-dimensional (3D) inversion recovery magnetic resonance (MR) imaging sequence is comparable with a clinically established two-dimensional (2D) multi-breath-hold sequence.
40 consecutive patients (18 men; mean age 50 ± 17) with either Fabry disease (n = 18) or HCM (n = 22) were enrolled in this prospective study. Studies were conducted on a 1.5-T clinical MR imaging system. Spatial resolution was the same for 3D and 2D images (field-of-view, 350 × 350 mm2; in-plane-resolution, 1.2 × 1.2 mm2; section-thickness, 8 mm). Datasets were analyzed for subjective image and quantitative evaluation of myocardial mass (grams), fibrotic mass (grams) and total fibrotic tissues percentage. Statistical analysis included Wilcoxon-signed-rank test, student's t-test for paired samples and Bland-Altman analysis.
There was no significant difference in subjective image quality between acquisitions (P > 0.1) for either disease. In patients with Fabry disease there was no significant differences in myocardial mass between 3D (100.7 g ± 30.8 g) and 2D acquisition(99.9 g ± 31.9 g; P = 0.55), as well as for fibrous tissue mass(3.9 g ± 6.4 g vs 4.0 ± 6.4 g; P = 0.89) and total fibrous percentage(3.4% ± 5.5%vs3.4 ± 5.5;P = 0.89). Bland-Altman analysis showed good agreement between 3D and 2D datasets for myocardial mass(mean difference: 0.8 g; limits of agreement: -10.2 g - 11.8 g), fibrous tissue mass (mean difference: -0.02 g; limits of agreement: -1.45 g-1.41 g), total fibrous percentage (mean difference:0.02%; limits of agreement: -1.31%-1.35%). In patients with HCM there was no significant differences in myocardial mass between 3D (115.5 g ± 33.3 g) and 2D acquisition (116.7 g ± 33.6 g;P = 0.48), as well as for fibrous tissue mass (5.6 g ± 8.6 g vs 5.7 g ± 8.7 g;P = 0.6) and total fibrous percentage (4.3% ± 6.4% vs 4.3% ± 6.5%;P = 0.89). Bland-Altman analysis showed good agreement between 3D and 2D datasets for myocardial mass (mean difference: -1.2 g;limits of agreement:-16.1 g - 13.7 g), fibrous tissue mass(mean difference -0.08 g;limits of agreement: -1.33 g - 1.17 g), total fibrous percentage(mean difference:-0.01 g;limits of agreement:-1.01 g-0.99 g). Acquisition time was significantly shorter for 3D sequences (24.9 seconds ± 5.2 seconds) as compared to 2D sequence (349.1 seconds ± 62.3 seconds, P < 0.001).
3D LGE imaging enables comparable quantification of fibrous myocardial tissue compared to a 2D sequence at a faster acquisition rate.
Nothing to disclose.
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