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Importance of standardized assessment of late gadolinium enhancement for quantification of infarct size by cardiac magnetic resonance: implications for comparison with electrocardiogram.
MedLine Citation:
PMID:  21872000     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Cardiac magnetic resonance (CMR) is currently considered the reference standard for in vivo assessment of myocardial infarction (MI). There is, however, no international consensus on how MI quantification from CMR should be performed. The aim of this study was to test how previously published manual quantification of MI using CMR images compares with MI quantification using a semiautomated, validated method and how this impacts the relationship with MI size estimated by 12-lead electrocardiogram (ECG).
METHODS: Twenty-five patients, from a previously published cohort, were included in the study. All patients had presented with clinical signs of acute coronary syndrome 6 to 12 months before undergoing a CMR examination. The patients had a standard 12-lead ECG recorded at the time of the CMR examination. The previously reported manually quantified MI size was compared with MI size determined using a semiautomated method validated by computer phantom data, experimental in vivo and ex vivo data, and patient data. The MI sizes from the 2 CMR approaches were then compared with the ECG-estimated MI size.
RESULTS: There was a strong correlation between MI size determined with the 2 CMR methods (r(2) = 0.94, P < .001). There was, however, a systematic overestimation of MI size of approximately 50% by the previously published manually quantified MI size compared with the semiautomated method. This affected the comparison with estimated MI size by ECG, which showed a significant underestimation of MI size compared with manual CMR measurements, but no bias compared with the semiautomated CMR method.
CONCLUSIONS: Manual quantification of MI size by CMR can differ significantly from semiautomated, validated methods taking partial volume effects into account and can lead to erroneous conclusions when compared with ECG.
Authors:
Annika Welinder; Nina Hakacova; Thomas Martin; Henrik Engblom
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  44     ISSN:  1532-8430     ISO Abbreviation:  J Electrocardiol     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-08-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  538-43     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Clinical Physiology, Lund University and Skåne University Hospital, Lund, Sweden.
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