The role of resting-state perfusion CMR in the evaluation of microvascular obstruction in patients with acute myocardial infarction: A clinical perspective
Objectives: To investigate the clinical application value of cardiac resting-state perfusion weight imaging (rs-PWI)-derived parameters in patients with acute myocardial infarction (AMI) complicated by microvascular obstruction (MVO). Methods: Overall, 300 patients with AMI were prospectively enroll...
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Elsevier
2025-06-01
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| Series: | European Journal of Radiology Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352047725000292 |
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| author | Yingying Hu Zidi Wang Zheng Sun Zhi Liu Jie Lu |
| author_facet | Yingying Hu Zidi Wang Zheng Sun Zhi Liu Jie Lu |
| author_sort | Yingying Hu |
| collection | DOAJ |
| description | Objectives: To investigate the clinical application value of cardiac resting-state perfusion weight imaging (rs-PWI)-derived parameters in patients with acute myocardial infarction (AMI) complicated by microvascular obstruction (MVO). Methods: Overall, 300 patients with AMI were prospectively enrolled, and divided into the MVO and non-MVO groups, based on the presence of MVO in the infarcted myocardium. Differences in rs-PWI imaging parameters, and the diagnostic value of rs-PWI in reperfusion myocardial ischemia at segment level and MVO were quantitatively evaluated. Results: The average age was 58.60 ± 13.03 years, and 246/300 (82 %) were males. The MVO group had 176 patients (mean age: 57.90 ± 12.47), including 140 (80 %) males. The left ventricular (LV) volumes occupied by the infarcted myocardium were 19.60 ± 2.70 %LV and 15.20 ± 3.40 %LV in the MVO and non-MVO groups, respectively (P < 0.05). There were 679 LGE positive segments in the MVO group (679/2816, 24.1 %). The area under curve (AUC), sensitivity, specificity, and Jordan index of rs-PWI for MVO diagnosis were 0.95(0.89–0.99), 94.3 %, 93.4 %, and 0.88, respectively. At the segmental level, the maximum rising slope was higher in the MVO than non-MVO group (15.09 ± 2.64 vs. 6.21 ± 1.25, P < 0.05). The time to peak 20 %-80 % was shorter in the MVO group (4.07 ± 0.79 vs. 7.75 ± 1.03, P < 0.05). Comparison revealed differences in perfusion indices (MVO: 0.32 ± 0.09 vs. non-MVO: 0.42 ± 0.04, P < 0.05). The highest diagnostic value for MVO among rs-PWI parameters was AUC 0.90(0.84–0.97), sensitivity 94.1 %, specificity 88.7 %, and accuracy 91.1 %. Conclusion: CMR rs-PWI sequence effectively evaluates reperfusion myocardial ischemia complicated with MVO, while the perfusion index has high diagnostic value in quantifying myocardial blood flow potential. |
| format | Article |
| id | doaj-art-e8e01939be234f86b1ddba7a6176abd1 |
| institution | OA Journals |
| issn | 2352-0477 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
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| series | European Journal of Radiology Open |
| spelling | doaj-art-e8e01939be234f86b1ddba7a6176abd12025-08-20T02:17:29ZengElsevierEuropean Journal of Radiology Open2352-04772025-06-011410066210.1016/j.ejro.2025.100662The role of resting-state perfusion CMR in the evaluation of microvascular obstruction in patients with acute myocardial infarction: A clinical perspectiveYingying Hu0Zidi Wang1Zheng Sun2Zhi Liu3Jie Lu4Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China; Department of Radiology, Peking University International Hospital, Beijing 102206, PR ChinaDepartment of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China; Yangjing Medical college, Capital Medical University, Beijing 101300, PR ChinaDepartment of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China; Correspondence to: Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, No. 45 of Changchun Street, Xicheng District, Beijing 100053, PR China.Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR ChinaDepartment of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China; Correspondence to: Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, No. 45 of Changchun Street, Xicheng District, Beijing 100053, PR China.Objectives: To investigate the clinical application value of cardiac resting-state perfusion weight imaging (rs-PWI)-derived parameters in patients with acute myocardial infarction (AMI) complicated by microvascular obstruction (MVO). Methods: Overall, 300 patients with AMI were prospectively enrolled, and divided into the MVO and non-MVO groups, based on the presence of MVO in the infarcted myocardium. Differences in rs-PWI imaging parameters, and the diagnostic value of rs-PWI in reperfusion myocardial ischemia at segment level and MVO were quantitatively evaluated. Results: The average age was 58.60 ± 13.03 years, and 246/300 (82 %) were males. The MVO group had 176 patients (mean age: 57.90 ± 12.47), including 140 (80 %) males. The left ventricular (LV) volumes occupied by the infarcted myocardium were 19.60 ± 2.70 %LV and 15.20 ± 3.40 %LV in the MVO and non-MVO groups, respectively (P < 0.05). There were 679 LGE positive segments in the MVO group (679/2816, 24.1 %). The area under curve (AUC), sensitivity, specificity, and Jordan index of rs-PWI for MVO diagnosis were 0.95(0.89–0.99), 94.3 %, 93.4 %, and 0.88, respectively. At the segmental level, the maximum rising slope was higher in the MVO than non-MVO group (15.09 ± 2.64 vs. 6.21 ± 1.25, P < 0.05). The time to peak 20 %-80 % was shorter in the MVO group (4.07 ± 0.79 vs. 7.75 ± 1.03, P < 0.05). Comparison revealed differences in perfusion indices (MVO: 0.32 ± 0.09 vs. non-MVO: 0.42 ± 0.04, P < 0.05). The highest diagnostic value for MVO among rs-PWI parameters was AUC 0.90(0.84–0.97), sensitivity 94.1 %, specificity 88.7 %, and accuracy 91.1 %. Conclusion: CMR rs-PWI sequence effectively evaluates reperfusion myocardial ischemia complicated with MVO, while the perfusion index has high diagnostic value in quantifying myocardial blood flow potential.http://www.sciencedirect.com/science/article/pii/S2352047725000292Cardiac magnetic resonanceResting-state perfusion weight imagingAcute myocardial infarctionMicrovascular obstruction |
| spellingShingle | Yingying Hu Zidi Wang Zheng Sun Zhi Liu Jie Lu The role of resting-state perfusion CMR in the evaluation of microvascular obstruction in patients with acute myocardial infarction: A clinical perspective European Journal of Radiology Open Cardiac magnetic resonance Resting-state perfusion weight imaging Acute myocardial infarction Microvascular obstruction |
| title | The role of resting-state perfusion CMR in the evaluation of microvascular obstruction in patients with acute myocardial infarction: A clinical perspective |
| title_full | The role of resting-state perfusion CMR in the evaluation of microvascular obstruction in patients with acute myocardial infarction: A clinical perspective |
| title_fullStr | The role of resting-state perfusion CMR in the evaluation of microvascular obstruction in patients with acute myocardial infarction: A clinical perspective |
| title_full_unstemmed | The role of resting-state perfusion CMR in the evaluation of microvascular obstruction in patients with acute myocardial infarction: A clinical perspective |
| title_short | The role of resting-state perfusion CMR in the evaluation of microvascular obstruction in patients with acute myocardial infarction: A clinical perspective |
| title_sort | role of resting state perfusion cmr in the evaluation of microvascular obstruction in patients with acute myocardial infarction a clinical perspective |
| topic | Cardiac magnetic resonance Resting-state perfusion weight imaging Acute myocardial infarction Microvascular obstruction |
| url | http://www.sciencedirect.com/science/article/pii/S2352047725000292 |
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