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...

Full description

Saved in:
Bibliographic Details
Main Authors: Yingying Hu, Zidi Wang, Zheng Sun, Zhi Liu, Jie Lu
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:European Journal of Radiology Open
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2352047725000292
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850182898210045952
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
record_format Article
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
work_keys_str_mv AT yingyinghu theroleofrestingstateperfusioncmrintheevaluationofmicrovascularobstructioninpatientswithacutemyocardialinfarctionaclinicalperspective
AT zidiwang theroleofrestingstateperfusioncmrintheevaluationofmicrovascularobstructioninpatientswithacutemyocardialinfarctionaclinicalperspective
AT zhengsun theroleofrestingstateperfusioncmrintheevaluationofmicrovascularobstructioninpatientswithacutemyocardialinfarctionaclinicalperspective
AT zhiliu theroleofrestingstateperfusioncmrintheevaluationofmicrovascularobstructioninpatientswithacutemyocardialinfarctionaclinicalperspective
AT jielu theroleofrestingstateperfusioncmrintheevaluationofmicrovascularobstructioninpatientswithacutemyocardialinfarctionaclinicalperspective
AT yingyinghu roleofrestingstateperfusioncmrintheevaluationofmicrovascularobstructioninpatientswithacutemyocardialinfarctionaclinicalperspective
AT zidiwang roleofrestingstateperfusioncmrintheevaluationofmicrovascularobstructioninpatientswithacutemyocardialinfarctionaclinicalperspective
AT zhengsun roleofrestingstateperfusioncmrintheevaluationofmicrovascularobstructioninpatientswithacutemyocardialinfarctionaclinicalperspective
AT zhiliu roleofrestingstateperfusioncmrintheevaluationofmicrovascularobstructioninpatientswithacutemyocardialinfarctionaclinicalperspective
AT jielu roleofrestingstateperfusioncmrintheevaluationofmicrovascularobstructioninpatientswithacutemyocardialinfarctionaclinicalperspective