Related Experiment Videos
Left ventricular thrombi: evaluation with spin-echo and gradient-echo MR imaging
M Jungehülsing1, U Sechtem, P Theissen
1Clinic and Outpatient Clinic for Nuclear Medicine, Universität zu Köln, Germany.
Insights
Gradient-echo (GRE) magnetic resonance (MR) imaging better detects left ventricular (LV) thrombi than spin-echo (SE) MR imaging. GRE MR imaging improved differentiation of thrombi from surrounding tissues, enhancing diagnostic accuracy for LV thrombi.
Area of Science:
- Cardiovascular Imaging
- Medical Diagnostics
- Magnetic Resonance Imaging
Background:
- Left ventricular (LV) thrombi are a significant complication of various cardiac conditions.
- Accurate detection of LV thrombi is crucial for appropriate patient management and therapeutic decisions.
- Conventional imaging techniques may have limitations in differentiating LV thrombi from normal cardiac structures.
Purpose of the Study:
- To compare the diagnostic performance of gradient-echo (GRE) and spin-echo (SE) magnetic resonance (MR) imaging in detecting chronic left ventricular thrombi.
- To evaluate the superiority of GRE imaging over SE imaging in visualizing and differentiating LV thrombi.
Main Methods:
- Retrospective analysis of MR imaging in 31 patients with suspected chronic LV thrombi.
- Comparison of GRE and SE sequences for thrombus detection and exclusion.
- Image evaluation by three independent reviewers, with diagnoses graded as unequivocal or probable.
- Surgical confirmation or other corroborative techniques used as a gold standard.
Main Results:
- GRE imaging unequivocally detected 16 of 18 confirmed thrombi, with 2 probable detections.
- SE imaging unequivocally detected 12 of 18 confirmed thrombi, with 5 probable detections and 1 missed thrombus.
- GRE imaging demonstrated improved differentiation of thrombi from myocardium and blood pool compared to SE imaging.
- GRE imaging showed higher accuracy in both thrombus detection and exclusion compared to SE imaging.
Conclusions:
- Gradient-echo (GRE) magnetic resonance (MR) imaging is diagnostically superior to spin-echo (SE) MR imaging for the detection of left ventricular (LV) thrombi.
- GRE imaging enhances visualization and differentiation of LV thrombi, leading to improved diagnostic accuracy.
- The findings support the use of GRE sequences in routine MR imaging protocols for evaluating patients with suspected LV thrombi.
Abstract:
Gradient-echo (GRE) and spin-echo (SE) magnetic resonance (MR) imaging was performed in 31 patients with chronic left ventricular (LV) thrombi. Thrombi were confirmed or excluded at surgery or by means of other corroborative diagnostic techniques. MR images were evaluated by three reviewers without knowledge of results of corroborative studies. Diagnoses were graded unequivocal if agreed on by three observers and probable if agreed on by two observers. With SE imaging, 12 of 18 confirmed thrombi were detected unequivocally, five were considered probable, and one was not detected. With GRE imaging, 16 of the 18 thrombi were visualized unequivocally; two were considered probable. With SE technique, thrombus was unequivocally excluded in nine of 13 cases and exclusion was considered probable in four. One finding was false-negative. Exclusion of thrombus with GRE imaging was unequivocal in 10 of 13 cases and probable in two, and one finding of thrombus was false-positive. GRE imaging resulted in improved differentiation of thrombi from the surrounding blood pool and myocardium and thus was diagnostically superior to SE imaging in detection of LV thrombi.