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Journal Article
Is a timely assessment of the hematocrit necessary for cardiovascular magnetic resonance–derived extracellular volume measurements?
2020
Overview
Background
Cardiovascular magnetic resonance (CMR)–derived extracellular volume (ECV) requires a hematocrit (Hct) to correct contrast volume distributions in blood. However, the timely assessment of Hct can be challenging and has limited the routine clinical application of ECV. The goal of the present study was to evaluate whether ECV measurements lead to significant error if a venous Hct was unavailable on the day of CMR.
Methods
109 patients with CMR T1 mapping and two venous Hcts (Hct
0
: a Hct from the day of CMR, and Hct
1
: a Hct from a different day) were retrospectively identified. A synthetic Hct (Hct
syn
) derived from native blood T1 was also assessed. The study used two different ECV methods, (1) a conventional method in which ECV was estimated from native and postcontrast T1 maps using a region-based method, and (2) an inline method in which ECV was directly measured from inline ECV mapping. ECVs measured with Hct
0
, Hct
1
, and Hct
syn
were compared for each method, and the reference ECV (ECV
0
) was defined using the Hct
0
. The error between synthetic (ECV
syn
) and ECV
0
was analyzed for the two ECV methods.
Results
ECV measured using Hct
1
and Hct
syn
were significantly correlated with ECV
0
for each method. No significant differences were observed between ECV
0
and ECV measured with Hct
1
(ECV
1
; 28.4 ± 6.6% vs. 28.3 ± 6.1%, p = 0.789) and between ECV
0
and ECV calculated with Hct
syn
(ECV
syn
; 28.4 ± 6.6% vs. 28.2 ± 6.2%, p = 0.45) using the conventional method. Similarly, ECV
0
was not significantly different from ECV
1
(28.5 ± 6.7% vs. 28.5 ± 6.2, p = 0.801) and ECV
syn
(28.5 ± 6.7% vs. 28.4 ± 6.0, p = 0.974) using inline method. ECV
syn
values revealed relatively large discrepancies in patients with lower Hcts compared with those with higher Hcts.
Conclusions
Venous Hcts measured on a different day from that of the CMR examination can still be used to measure ECV. ECV
syn
can provide an alternative method to quantify ECV without needing a blood sample, but significant ECV errors occur in patients with severe anemia.
Publisher
BioMed Central,BioMed Central Ltd,Elsevier
Subject
/ Adult
/ Aged
/ Anemia
/ Blood
/ Cardiovascular magnetic resonance
/ Contrast Media - administration & dosage
/ Extracellular volume fraction
/ Female
/ Fibrosis
/ Heart Diseases - diagnostic imaging
/ Humans
/ Imaging
/ Male
/ Mapping
/ Medicine
/ Meglumine - administration & dosage
/ Methods
/ Organometallic Compounds - administration & dosage
/ Organometallic Compounds - blood
/ Patients
/ Software
