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Co-analysis of Brain Structure and Function using fMRI and Diffusion-weighted Imaging
Published on: November 8, 2012
Myocardial fibrosis evaluated by diffusion-weighted imaging and its relationship to 3D contractile function in
Rui Wu1, Dong-Aolei An1, Ruo-Yang Shi1
1Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Background:
Previous studies have shown that diffusion-weighted imaging (DWI) is sensitive to myocardial fibrosis in ischemic and nonischemic cardiomyopathy.
Purpose:
To explore the prognostic value of apparent diffusion coefficient (ADC) for detecting myocardial fibrosis and its relationship to the contractile function in hypertrophic cardiomyopathy (HCM).
Study Type:
Prospective.
Population:
A total of 45 HCM patients and 20 controls.
Field Strength/Sequence:
3.0T cardiac MRI. The cardiac MR sequences included cine, T1 mapping, and DWI.
Assessment:
According to the presence of late gadolinium enhancement (LGE) and the extracellular volume (ECV) values (+2 SD of control subjects), respectively, reader W and reader J assessed the value of ADC of each segment for detecting myocardial fibrosis and its relationship to impaired contractile function in HCM patients.
Statistical Tests:
Independent sample t-test, Pearson analysis, and intraclass correlation (ICC).
Results:
The value of ECV was 23.6 ± 3.0% for control. ECV ≥ 29.6% and ECV < 29.6% groups were classified. ADC values in the ECV ≥ 29.6% group were significantly increased compared to the ECV < 29.6% group, (2.41 ± 0.23 μm2 /ms vs. 2.03 ± 0.16 μm2 /ms, P < 0.005). Compared to the LGE - group, ECV (32.1 ± 2.3% vs. 29.0 ± 2.8%, P < 0.005) and ADC (2.60 ± 0.18 μm2 /ms vs. 2.10 ± 0.07 μm2 /ms, P < 0.005) values were significantly increased in the LGE + group. ADC values were linearly associated with ECV values (R2 = 0.65) in HCM patients. ADC values were linearly associated with circumferential and longitudinal strain (R2 = 0.60, R2 = 0.46), as well as circumferential, longitudinal, and radial strain rate (R2 = 0.13, R2 = 0.25, R2 = 0.17, respectively).
Data Conclusion:
Contractile dysfunction in HCM is predominantly associated with ADC, which is a feasible alternative to ECV and LGE for detecting myocardial fibrosis.
Level Of Evidence:
1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;48:1139-1146.
Insights
Apparent diffusion coefficient (ADC) effectively detects myocardial fibrosis in hypertrophic cardiomyopathy (HCM). ADC correlates with extracellular volume and contractile function, offering a viable alternative to LGE and ECV for fibrosis assessment.
Area of Science:
- Cardiovascular Imaging
- Biomedical Engineering
- Radiology
Background:
- Diffusion-weighted imaging (DWI) demonstrates sensitivity to myocardial fibrosis in various cardiomyopathies.
- Hypertrophic cardiomyopathy (HCM) is characterized by myocardial fibrosis and impaired contractile function.
Purpose of the Study:
- To investigate the prognostic value of apparent diffusion coefficient (ADC) in detecting myocardial fibrosis within HCM.
- To explore the relationship between ADC, myocardial fibrosis, and contractile function in HCM patients.
Main Methods:
- A prospective study involving 45 HCM patients and 20 controls using 3.0T cardiac MRI.
- Cardiac MR sequences included cine, T1 mapping, and DWI.
- Assessment of ADC values for myocardial fibrosis detection and correlation with extracellular volume (ECV) and late gadolinium enhancement (LGE).
Main Results:
- ADC values were significantly increased in patients with higher ECV and LGE, indicating greater fibrosis.
- ADC showed a strong linear association with ECV (R²=0.65).
- ADC values correlated significantly with impaired circumferential and longitudinal strain and strain rates.
Conclusions:
- Apparent diffusion coefficient (ADC) is a feasible and effective tool for detecting myocardial fibrosis in HCM.
- ADC serves as a valuable alternative to ECV and LGE for assessing fibrosis and its impact on contractile dysfunction in HCM.
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