Diagnostic value of cardiac magnetic contrast-enhanced cine sequences in STEMI patients with microvascular obstruction
Objective:Using magnetic resonance contrast enhancement-steady state free precession(CE-SSFP)cine sequence to detect ST-segment elevation myocardial infarction(STEMI)in elderly patients with microvascular obstruction(MVO).STEMI patients were evaluated for image quality and combined with sequence parameter analysis to further explore its diagnostic performance for MVO.Materials and Methods:The clinical data of 50 patients with STEMI(STEMI group)from September 2016 to March 2023 were retrospectively analyzed.All patients underwented CE-SSFP cine sequence short axis,four chamber,and two chamber scans.The STEMI patient group was included according to the 2020 European Heart Journal guideline standards and healthy controls matched for gender and age were collected.Qualitative and quantitative image quality evaluation of the myocardium and blood pool were performed on the CE-SSFP sequence by two diagnostic radiologists.The independent sample t test was used to analyze the general information and imaging data between the STEMI group and the healthy control group.The diagnostic performance of CE-SSFP sequence for MVO was analyzed using receiver operating characteristic(ROC)curve.Results:The CE-SSFP images of 48 patients(96%)in the STEMI group and 49 volunteers(98%)in the healthy control group could meet the diagnostic conditions;the contrast-to-noise ratio of the blood pool and myocardium in the STEMI group was significantly better than that in the healthy control group(222.9±15.6 vs.170.1±14.9,t=4.631,P<0.05);the sensitivity of CE-SSFP to manually identify MVO was 91.38%,the specificity was 91.88%,and the Youden index was 0.833;the sensitivity of MVO was evaluated with 2 times the standard deviation.The specificity was 90.23%,the specificity was 89.94%,and the Youden index was 0.802.The areas under the curve for the two methods were 0.931 and 0.909 respectively.Conclusions:The CE-SSFP sequence can quantitatively evaluate the image quality of patients with STEMI combined with MVO,provide effective indicators for quantitatively identifying MVO,and provide imaging basis for clinical diagnosis.
ST-segment elevation myocardial infarctionmicrovascular obstructioncardiac magnetic resonancecontrast enhancement-steady state free precessionmagnetic resonance imaging