Tesi etd-10132025-155224 |
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Tipo di tesi
Tesi di specializzazione (4 anni)
Autore
LUCCHI, GIACOMO
URN
etd-10132025-155224
Titolo
Flip Angle Mapping Without Gadolinium Enhancement in the Magnetic Resonance Imaging Assessment of Myocardial Injury
Dipartimento
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
RADIODIAGNOSTICA
Relatori
relatore Prof. Neri, Emanuele
relatore Prof. Aquaro, Giovanni Donato
relatore Prof. Aquaro, Giovanni Donato
Parole chiave
- cardiac magnetic resonance imaging
- flip angle mapping
- myocardial infarction
Data inizio appello
08/11/2025
Consultabilità
Non consultabile
Data di rilascio
08/11/2028
Riassunto
Background: Evaluation of cine-SSFP images acquired at different flip angles (Flip Angle Mapping, FAM) may allow non-contrast identification of acute and chronic myocardial infarction (MI).
Methods: Fifteen young pigs underwent 90-minute occlusion of the left anterior descending artery via thoracotomy. Cardiac MRI was performed within 1 week (acute phase) and at 1 month. Cine-SSFP was acquired at flip angle values of 15°, 30°, 45°, 60°, and 75°, while Late Gadolinium Enhancement (LGE) served as reference. ROIs were placed in blood, infarcted myocardium (LGE-matched), remote myocardium, and skeletal muscle. Signal/flip-angle curves were generated; for each tissue, the integral was calculated and expressed as a ratio to the blood curve integral.
Results: The integral ratio was significantly higher in infarcted vs remote myocardium and skeletal muscle in both end-diastole (p<0.001) and end-systole (p<0.001) in the acute phase; similar findings were observed at 1 month. ROC analysis showed that in acute MI a cut-off >0.45 detected necrosis with 100% sensitivity and 93% specificity (AUC=0.97), while at 1 month a cut-off >0.44 identified infarction with 100% sensitivity and 86% specificity (AUC=0.98).
Conclusion: FAM enables non-contrast discrimination of acute and chronic MI from healthy myocardium. Further studies should compare FAM-based mapping with LGE and explore clinical translation.
Methods: Fifteen young pigs underwent 90-minute occlusion of the left anterior descending artery via thoracotomy. Cardiac MRI was performed within 1 week (acute phase) and at 1 month. Cine-SSFP was acquired at flip angle values of 15°, 30°, 45°, 60°, and 75°, while Late Gadolinium Enhancement (LGE) served as reference. ROIs were placed in blood, infarcted myocardium (LGE-matched), remote myocardium, and skeletal muscle. Signal/flip-angle curves were generated; for each tissue, the integral was calculated and expressed as a ratio to the blood curve integral.
Results: The integral ratio was significantly higher in infarcted vs remote myocardium and skeletal muscle in both end-diastole (p<0.001) and end-systole (p<0.001) in the acute phase; similar findings were observed at 1 month. ROC analysis showed that in acute MI a cut-off >0.45 detected necrosis with 100% sensitivity and 93% specificity (AUC=0.97), while at 1 month a cut-off >0.44 identified infarction with 100% sensitivity and 86% specificity (AUC=0.98).
Conclusion: FAM enables non-contrast discrimination of acute and chronic MI from healthy myocardium. Further studies should compare FAM-based mapping with LGE and explore clinical translation.
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