Clinical Application Of Magnetic Resonance Imaging On Left Ventricular Aneurysm In Patients With Coronary Artery Disease

Objective An accurate evaluation of the left ventricular morphology and function is a crucial step before surgical correction. However, this is limited by the traditional imagine technologies such as the left ventricular angiography and echocardiography. The present study aims to apply the state-of-the-art magnetic resonance imaging (MRI) to the quantification of left ventricular aneurysm in patients with coronary artery disease.Methods 18 subjects participated in the study. All subjects were diagnosed as left ventricular aneurysm (LVA) with coronary artery disease using both left ventricular angiography and echocardiography. MRI was also applied to each subject before and after the surgical correction of LVA. The study assessed the application of MRI from three aspects. Firstly, the non-invasive MRI tagging technique was used before operation to provide information on the LV wall movement and myocardial viability. Secondly, a group of morphological and functional measures were collected using two-dimensional echocardiography and MRI for each patient. These measures are the left ventricular volume,ejection fraction and the size of LVA. The results from different methods were compared statistically. Thirdly, left ventricular sphericity index and inter-papillary muscle distance were measured in all patients using MRI before and after operation.Results The present study has three major findings: First, MRI tagging technique is able to differentiate kinetics from dyskinetics and akinetics. In addition, myocardial viability can be recognized using wall thickness combined with late contrast enhancement. Second, echocardiography significantly underestimated the LV size and volume (p<0.05) in patients with LVA. Last, after surgical management the left ventricular sphericity index shows no significant difference compared to before while the inter-papillary muscle distance is significantly shortened (p<0.05) .Conclusion The present study has demonstrated that MRI is able to provide more comprehensive and accurate morphological and functional measures of LVA compared to the traditional imaging technologies. Future application of MRI is promising to confirm the diagnosis,evaluate the disease progress,determine the type of operation and to predict clinical improvement after surgical management. Obective To evaluate the accuracy and value of measurement of left ventricule volume and function with realtime three-dimensional echocardiography in patients with left ventricular aneurysm.Methods left ventricule end diastolic volume(LVEDV),left ventricule end systolic volume(LVESV),left ventricule ejection fraction(EF) before and after operation were measured with 2DE,RT-3DE and MRI.Results Before operation, LVEDV and LVESV obtained with 2DE and RT-3DE are smaller than those obtained with MRI, LVEF obtained with 2DE and RT-3DE are more larger than those obtained with MRI (p<0.05) . After operation, LVEDV and LVESV obtained with 2DE are still smaller than those obtained with MRI (p<0.05) , no significant differences between those obtained with RT-3DE and MRI.Conclusion RT-3DE can accurately measure the left ventricule volume and function than 2DE. But before operation, in patients with left ventricular aneurysm, LVEDV and LVESV obtained with RT-3DE are still underestimated.