Idiopathic inflammatory myopathies (IIM) is a group of heterogeneous autoimmune systemic diseases, which not only involve skeletal muscle but also myocardium. Cardiac involvement in IIM, which... Show moreIdiopathic inflammatory myopathies (IIM) is a group of heterogeneous autoimmune systemic diseases, which not only involve skeletal muscle but also myocardium. Cardiac involvement in IIM, which eventually develops into heart failure, is difficult to identify by conventional examinations at early stage. The aim of this study was to investigate if multi-parametric cardiac magnetic resonance (CMR) imaging can screen for early cardiac involvement in IIM, compared with clinical score (Myositis Disease Activity Assessment Tool, MDAAT). Forty-nine patients of IIM, and 25 healthy control subjects with comparable age-range and sex-ratio were enrolled in this study. All subjects underwent CMR examination, and multi-slice short-axis and 4-chamber cine MRI were acquired to evaluate biventricular global circumferential strain (GCS) and global longitudinal strain (GLS). Native T1 and T2 mapping were performed, and post-contrast T1 mapping and LGE were acquired after administration of contrast. A CMR score was developed from native T1 mean and T2 mean for the identification of cardiac involvement in the IIM cohort. Using contingency tables MDAAT and CMR were compared and statistically analyzed using McNemar test. McNemar's test revealed no significant difference between CMR score and MDAAT (p = 0.454). CMR score had potential to screen for early cardiac involvement in IIM patients, compared to MDAAT. Show less
OBJECTIVES This study evaluated cardiac involvement in patients recovered from coronavirus disease-2019 (COVID-19) using cardiac magnetic resonance (CMR).BACKGROUND Myocardial injury caused by... Show moreOBJECTIVES This study evaluated cardiac involvement in patients recovered from coronavirus disease-2019 (COVID-19) using cardiac magnetic resonance (CMR).BACKGROUND Myocardial injury caused by COVID-19 was previously reported in hospitalized patients. It is unknown if there is sustained cardiac involvement after patients' recovery from COVID-19.METHODS Twenty-six patients recovered from COVID-19 who reported cardiac symptoms and underwent CMR examinations were retrospectively included. CMR protocols consisted of conventional sequences (cine, T2-weighted imaging, and late gadolinium enhancement [LGE]) and quantitative mapping sequences (T1, T2, and extracellular volume [ECV] mapping). Edema ratio and LGE were assessed in post-COVID-19 patients. Cardiac function, native T1/T2, and ECV were quantitatively evaluated and compared with controls.RESULTS Fifteen patients (58%) had abnormal CMR findings on conventional CMR sequences: myocardial edema was found in 14 (54%) patients and LGE was found in 8 (31%) patients. Decreased right ventricle functional parameters including ejection fraction, cardiac index, and stroke volume/body surface area were found in patients with positive conventional CMR findings. Using quantitative mapping, global native T1, T2, and ECV were all found to be significantly elevated in patients with positive conventional CMR findings, compared with patients without positive findings and controls (median [interquartile range]: native T1 1,271 ms [1,243 to 1,298 ms] vs. 1,237 ms [1,216 to 1,262 ms] vs. 1,224 ms [1,217 to 1,245 ms]; mean +/- SD: T2 42.7 +/- 3.1 ms vs. 38.1 ms +/- 2.4 vs. 39.1 ms +/- 3.1; median [interquartile range]: 28.2% [24.8% to 36.2%] vs. 24.8% [23.1% to 25.4%] vs. 23.7% [22.2% to 25.2%]; p = 0.002; p < 0.001, and p =0.002, respectively).CONCLUSIONS Cardiac involvement was found in a proportion of patients recovered from COVID-19. CMR manifestation included myocardial edema, fibrosis, and impaired right ventricle function. Attention should be paid to the possible myocardial involvement in patients recovered from COVID-19 with cardiac symptoms. (C) 2020 by the American College of Cardiology Foundation. Show less
Background: Chest CT is used in the diagnosis of coronavirus disease 2019 (COVID-19) and is an important complement to reverse-transcription polymerase chain reaction (RT-PCR) tests.Purpose: To... Show moreBackground: Chest CT is used in the diagnosis of coronavirus disease 2019 (COVID-19) and is an important complement to reverse-transcription polymerase chain reaction (RT-PCR) tests.Purpose: To investigate the diagnostic value and consistency of chest CT as compared with RT-PCR assay in COVID-19.Materials and Methods: This study included 1014 patients in Wuhan, China, who underwent both chest CT and RT-PCR tests between January 6 and February 6, 2020. With use of RT-PCR as the reference standard, the performance of chest CT in the diagnosis of COVID-19 was assessed. In addition, for patients with multiple RT-PCR assays, the dynamic conversion of RT-PCR results (negativeto positive, positive to negative) was analyzed as compared with serial chest CT scans for those with a time interval between RT-PCR tests of 4 days or more.Results: Of the 1014 patients, 601 of 1014 (59%) had positive RT-PCR results and 888 of 1014 (88%) had positive chest CT scans. The sensitivity of chest CT in suggesting COVID-19 was 97% (95% confidence interval: 95%, 98%; 580 of 601 patients) based on positive RT-PCR results. In the 413 patients with negative RT-PCR results, 308 of 413 (75%) had positive chest CT findings. Of those 308 patients, 48% (103 of 308) were considered as highly likely cases and 33% (103 of 308) as probable cases. At analysis of serial RT-PCR assays and CT scans, the mean interval between the initial negative to positive RT-PCR results was 5.1 days +/- 1.5; the mean interval between initial positive to subsequent negative RT-PCR results was 6.9 days +/- 2.3. Of the 1014 patients, 60% (34 of 57) to 93% (14 of 15) had initial positive CT scans consistent with COVID-19 before (or parallel to) the initial positive RT-PCR results. Twenty-four of 57 patients (42%) showed improvement on follow-up chest CT scans before the RT-PCR results turned negative.Conclusion: Chest CT has a high sensitivity for diagnosis of coronavirus disease 2019 (COVID-19). Chest CT may be considered as a primary tool for the current COVID-19 detection in epidemic areas. (C) RSNA, 2020 Show less
Purpose Cardiac motion tracking enables quantitative evaluation of myocardial strain, which is clinically interesting in cardiovascular disease research. However, motion tracking is difficult to... Show morePurpose Cardiac motion tracking enables quantitative evaluation of myocardial strain, which is clinically interesting in cardiovascular disease research. However, motion tracking is difficult to perform manually. In this paper, we aim to develop and compare two fully automated motion tracking methods for the steady state free precession (SSFP) cine magnetic resonance imaging (MRI), and explore their use in real clinical scenario with different patient groups. Methods We proposed two automated cardiac motion tracking method: (a) a traditional registration-based method, named full cardiac cycle registration, which simultaneously tracks all cine frames within a full cardiac cycle by joint registration of all frames; and (b) a modern convolutional neural network (CNN)-based method, named Groupwise MotionNet, which enhances the temporal coherence by fusing motion along a continuous time scale. Both methods were evaluated on the healthy volunteer data from the MICCAI 2011 STACOM Challenge, as well as on patient data including hypertrophic cardiomyopathy (HCM) and myocardial infarction (MI). Results The full cardiac cycle registration method achieved an average end-point error (EPE) 2.89 +/- 1.57 mm for cardiac motion tracking, with computation time of around 9 min per short-axis cine MRI (size 128 x 128, 30 cardiac phases). In comparison, the Groupwise MotionNet achieved an average EPE of 0.94 +/- 1.59 mm, taking < 1 s for a full cardiac phases. Further experiments showed that registration method had stable performance, independent of patient cohort and MRI machine, while the CNN-based method relied on the training data to deliver consistently accurate results. Conclusion Both registration-based and CNN-based method can track the cardiac motion from SSFP cine MRI in a fully automated manner, while taking temporal coherence into account. The registration method is generic, robust, but relatively slow; the CNN-based method trained with heterogeneous data was able to achieve high tracking accuracy with real-time performance. Show less
Tao, Q.; Yan, W.J.; Wang, Y.Y.; Paiman, E.H.M.; Shamonin, D.P.; Garg, P.; ... ; Geest, R.J. van der 2019
Objective: The aim of this study was to examine the local myocardial segments in hypertrophic cardiomyopathy (HCM) by MRI T1 and T2 mapping, and to investigate how tissue remodeling correlates with... Show moreObjective: The aim of this study was to examine the local myocardial segments in hypertrophic cardiomyopathy (HCM) by MRI T1 and T2 mapping, and to investigate how tissue remodeling correlates with structural and functional remodeling in HCM.Methods: 47 patients with HCM and 19 healthy volunteers were enrolled in this study. All subjects underwent cardiac MRI at 3.0 T. Native T1 and T2 values, end-diastolic wall thickness (EDTH), and percentage of systolic wall thickening (PSWT) were assessed in the left ventricular segments according to the American Heart Association model. Myocardial segments were categorized as normal, non-hypertrophic, mild-hypertrophic, moderate-hypertrophic, and severe-hypertrophic based on EDTH. The difference among all five groups, and the correlation between native T1 and T2 values, EDTH, and PSWT were evaluated.Results: Native T1 and T2 values were significantly elevated in both non-hypertrophic and hypertrophic segments of HCM patients compared to controls (both p < 0.001). PSWT was preserved in non-hypertrophic segments (p = 0.838), while significantly impaired < 0.001) in hypertrophic segments. Native T1 value of severe hypertrophic segments in HCM was significantly higher than segments of mild and moderate hypertrophy (p < 0.05).Conclusion: In HCM patients, the non-hypertrophic myocardial segments already demonstrated significantly elevated T1 and T2 values, despite normal wall thickness and preserved contraction function. The finding suggests that tissue remodeling may precede morphological and functional remodeling in HCM. MRI native T1 and T2 mapping can provide additional value for HCM diagnosis at an early stage.Advances in knowledge: Myocardial tissue remodeling, as detected by MRI native T1 and T2 mapping, occurs earlier than morphological and functional changes in HCM patients. Show less
