Left Atrial Myocardial Fibrosis Assessment by 3D High-resolution Late Gadolinium Enhancement MRI in Patients With Atrial Fibrillation:a Feasibility Study
10.3969/j.issn.1000-3614.2024.07.008
- VernacularTitle:三维高分辨力磁共振钆延迟增强成像评估心房颤动患者左心房心肌纤维化的可行性研究
- Author:
Leyi ZHU
1
;
Shuo YUAN
;
Yining WANG
;
Kang AN
;
Wenjing YANG
;
Haojie LI
;
Gang YIN
;
Shihua ZHAO
;
Minjie LU
;
Zhe ZHENG
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 磁共振影像科,北京 100037
- Keywords:
magnetic resonance imaging;
atrial fibrillation;
late gadolinium enhancement;
myocardial fibrosis
- From:
Chinese Circulation Journal
2024;39(7):703-709
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To investigate the clinical feasibility of three-dimensional(3D)high-resolution late gadolinium enhancement(LGE)MRI in accessing left atrial myocardial fibrosis in patients with atrial fibrillation(AF). Methods:A total of 34 AF patients referred for hybrid surgical ablation were retrospectively enrolled in this study.3D-LGE-MRI images were acquired by Siemens 3.0 T machine and analyzed by ADAS post-processing software by two experienced radiologists to obtain parameters such as the area and the area percentage of LGE.Regional analysis was performed by one of the two radiologists at ten left atrial segments.The Kappa test was used to assess the agreement for scoring image quality,and the interclass correlation coefficient(ICC)was used to evaluate the interobserver agreement of LGE parameters.The parameters of left atrial morphology,area(and area percentage)of LGE,and location of LGE were compared between patients with persistent AF and paroxysmal AF. Results:Images of all 34 patients were considered to have diagnostic value.The scores of the overall image quality and the clarity of the left atrial wall evaluated by two radiologists were(2.88±0.64)points and(3.26±0.75)points(radiologist 1),(2.97±0.58)points and(3.24±0.70)points(radiologist 2),respectively.The corresponding Kappa values were 0.724 and 0.859.Both the area and the area percentage of LGE showed good consistency among observers,and the ICCs were 0.969 and 0.950,respectively.The difference in the area of LGE and the area percentage of LGE between patients with paroxysmal and persistent atrial fibrillation was similar(both P＞0.05).Compared with patients with paroxysmal AF,patients with persistent AF had a higher Utah stage and more severe myocardial fibrosis in the right inferior pulmonary vein antrum and the left atrial septum(all P＜0.05). Conclusions:3D high-resolution LGE-MRI provides a non-invasive way to visualize and quantify left atrial myocardial fibrosis.The extent of left atrial fibrosis in patients with persistent AF is more severe than that in patients with paroxysmal AF,with a preferential distribution in the right inferior pulmonary vein antrum and the left atrial septum.
