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JACQUIER Alexis

MD PhD

alexis.jacquier@ap-hm.fr
tel : +33 4 91 38 84 57
Key Words
- Dilated cardiomyopathy
- Fibrosis quantification
- Treadmill exercise during cardiac MRI

Current Research Interest and projects

Publications

2018

Journal Article

  • Salaun, E, Sportouch, L, Barral, P-A, Hubert, S, Lavoute, C, Casalta, A-C, Pradier, J, Ouk, D, Casalta, J-P, Lambert, M, Gouriet, F, Gaubert, J-Y, Dehaene, A, Jacquier, A, Tessonnier, L, Haentjens, J, Theron, A, Riberi, A, Cammilleri, S, Grisoli, D, Jaussaud, N, Collart, F, Bonnet, J-L, Camoin, L, Renard, S, Cuisset, T, Avierinos, J-F, Lepidi, H, Mundler, O, Raoult, D & Habib, G 2018, “Diagnosis of Infective Endocarditis After TAVR: Value of a Multimodality Imaging Approach”, JACC. Cardiovascular imaging, vol. 11, no. 1, p. 143-146.
    Mots-clés : infective endocarditis, multi-imaging, PET/CT, TAVI, TAVR.

2017

Journal Article

  • Achenbach, S, Paul, J-F, Laurent, F, Becker, H-C, Rengo, M, Caudron, J, Leschka, S, Vignaux, O, Knobloch, G, Benea, G, Schlosser, T, Andreu, J, Cabeza, B, Jacquier, A, Souto, M, Revel, D, Qanadli, SD, Cademartiri, F & X-ACT Study Group, 2017, “Erratum to: Comparative assessment of image quality for coronary CT angiography with iobitridol and two contrast agents with higher iodine concentrations: iopromide and iomeprol. A multicentre randomized double-blind trial”, European Radiology, vol. 27, no. 2, p. 831.

  • Alory, A, Jacquier, A, Gentien, D, de la Grange, P & Haase, G 2017, “[Neurotrophic factors for motor neurons: an à la carte menu]”, Medecine Sciences: M/S, vol. 33, no. 10, p. 835-839.

  • Barral, P-A, De Masi-Jacquier, M, Gaudry, M, Boutboul, D, Bartoli, J-M, Jacquier, A & Piquet, P 2017, “Three-Dimensional to Three-Dimensional Image Fusion-Guided Thoracic Endovascular Aortic Repair without Iodine Injection”, Journal of vascular and interventional radiology: JVIR, vol. 28, no. 8, p. 1201-1203.

  • Escudier, M, Cautela, J, Malissen, N, Ancedy, Y, Orabona, M, Pinto, J, Monestier, S, Grob, J-J, Scemama, U, Jacquier, A, Lalevee, N, Barraud, J, Peyrol, M, Laine, M, Bonello, L, Paganelli, F, Cohen, A, Barlesi, F, Ederhy, S & Thuny, F 2017, “Clinical Features, Management, and Outcomes of Immune Checkpoint Inhibitor-Related Cardiotoxicity”, Circulation, vol. 136, no. 21, p. 2085-2087.
    Mots-clés : cardiotoxicity, immunotherapy, neoplasms.

  • Gaborit, B, Sengenes, C, Ancel, P, Jacquier, A & Dutour, A 2017, “Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat?”, Comprehensive Physiology, vol. 7, no. 3, p. 1051-1082.
    Résumé : Epicardial adipose tissue (EAT) is a small but very biologically active ectopic fat depot that surrounds the heart. Given its rapid metabolism, thermogenic capacity, unique transcriptome, secretory profile, and simply measurability, epicardial fat has drawn increasing attention among researchers attempting to elucidate its putative role in health and cardiovascular diseases. The cellular crosstalk between epicardial adipocytes and cells of the vascular wall or myocytes is high and suggests a local role for this tissue. The balance between protective and proinflammatory/profibrotic cytokines, chemokines, and adipokines released by EAT seem to be a key element in atherogenesis and could represent a future therapeutic target. EAT amount has been found to predict clinical coronary outcomes. EAT can also modulate cardiac structure and function. Its amount has been associated with atrial fibrillation, coronary artery disease, and sleep apnea syndrome. Conversely, a beiging fat profile of EAT has been identified. In this review, we describe the current state of knowledge regarding the anatomy, physiology and pathophysiological role of EAT, and the factors more globally leading to ectopic fat development. We will also highlight the most recent findings on the origin of this ectopic tissue, and its association with cardiac diseases. © 2017 American Physiological Society. Compr Physiol 7:1051-1082, 2017.
    Mots-clés : cvs.

  • Habib, G, Bucciarelli-Ducci, C, Caforio, ALP, Cardim, N, Charron, P, Cosyns, B, Dehaene, A, Derumeaux, G, Donal, E, Dweck, MR, Edvardsen, T, Erba, PA, Ernande, L, Gaemperli, O, Galderisi, M, Grapsa, J, Jacquier, A, Klingel, K, Lancellotti, P, Neglia, D, Pepe, A, Perrone-Filardi, P, Petersen, SE, Plein, S, Popescu, BA, Reant, P, Sade, LE, Salaun, E, Slart, RHJA, Tribouilloy, C, Zamorano, J, EACVI Scientific Documents Committee, & Indian Academy of Echocardiography, 2017, “Multimodality Imaging in Restrictive Cardiomyopathies: An EACVI expert consensus document In collaboration with the "Working Group on myocardial and pericardial diseases" of the European Society of Cardiology Endorsed by The Indian Academy of Echocardiography”, European Heart Journal Cardiovascular Imaging, vol. 18, no. 10, p. 1090-1121.
    Résumé : Restrictive cardiomyopathies (RCMs) are a diverse group of myocardial diseases with a wide range of aetiologies, including familial, genetic and acquired diseases and ranging from very rare to relatively frequent cardiac disorders. In all these diseases, imaging techniques play a central role. Advanced imaging techniques provide important novel data on the diagnostic and prognostic assessment of RCMs. This EACVI consensus document provides comprehensive information for the appropriateness of all non-invasive imaging techniques for the diagnosis, prognostic evaluation, and management of patients with RCM.

  • Marcelin, C, Izaaryene, J, Castelli, M, Barral, PA, Jacquier, A, Vidal, V & Bartoli, JM 2017, “Embolization of ovarian vein for pelvic congestion syndrome with ethylene vinyl alcohol copolymer (Onyx®)”, Diagnostic and Interventional Imaging, vol. 98, no. 12, p. 843-848.
    Résumé : PURPOSE: To evaluate the safety and efficacy of pelvic embolization using ethylene vinyl alcohol copolymer (Onyx®) for pelvic congestion syndrome. MATERIAL AND METHODS: Between March 2012 to September 2016, 17 women (mean age, 44.7± 12.2 (SD) years; range: 34-71years) presenting with pelvic congestion syndrome were evaluated for transvenous embolization with Onyx®. Pelvic congestion syndrome was initially diagnosed by clinical examination and the results of transvaginal Doppler ultrasound and further confirmed by pelvic venography. Primary and secondary clinical efficacy was defined respectively by the resolution of the symptoms after embolization and at the end of the follow-up, irrespective to the number of embolization procedures. RESULTS: Technical efficacy of embolization was 100% with no significant complications during and after embolization. After a mean follow-up time of 24.2 months (range: 6-69months) a primary and secondary clinical efficacy of 76.4% (13/17 women) and 94.1% (16/17 women) respectively were observed. Four women (23.5%) underwent a second embolization procedure with one woman requiring a third embolization procedure. These additional embolization procedures were associated with direct puncture of vulvar varices for sclerotherapy in two women. Five women (29%) had recurrent symptoms 21 months post-treatment (7-42months). CONCLUSION: Pelvic embolization using ethylene vinyl alcohol copolymer (Onyx®) has a favorable clinical success for pelvic congestion syndrome.
    Mots-clés : Chronic pelvic syndrome, Embolization, Onyx(®), Pelvic congestion syndrome, Safety.

  • Roux, V, Salaun, E, Tribouilloy, C, Hubert, S, Bohbot, Y, Casalta, J-P, Barral, P-A, Rusinaru, D, Gouriet, F, Lavoute, C, Haentjens, J, Di Biscegli, M, Dehaene, A, Renard, S, Casalta, A-C, Pradier, J, Avierinos, J-F, Riberi, A, Lambert, M, Collart, F, Jacquier, A, Thuny, F, Camoin-Jau, L, Lepidi, H, Raoult, D & Habib, G 2017, “Coronary events complicating infective endocarditis”, Heart (British Cardiac Society), vol. 103, no. 23, p. 1906-1910.
    Résumé : OBJECTIVE: Acute coronary syndromes (ACS) are a rare complication of infective endocarditis (IE). Only case reports and small studies have been published to date. We report the largest series of ACS in IE. The aim of our study was to describe the incidence and mechanisms of ACS associated with IE, to assess their prognostic impact and to describe their management. METHODS: In a bicentre prospective observational cohort study, all patients with a definite diagnosis of IE were prospectively included. The incidence, mechanism and prognosis of patients with ACS were studied. RESULTS: Among 1210 consecutive patients with definite IE, 26 patients (2.2%) developed an ACS. Twenty-three patients (88%) had a coronary embolism. Two patients had coronary compression by an abscess or a pseudoaneurysm and one patient had an obstruction of his bioprosthesis and left coronary ostium by a large vegetation. Nineteen (73%) patients with ACS developed heart failure and this complication was 2.5 times more frequent than in patients without ACS (p<0.0001). In the ACS population, mortality rate was twice than the population without ACS. CONCLUSIONS: ACS is a rare complication of IE but is associated with an increased risk of heart failure and high mortality rate.
    Mots-clés : Acute Coronary Syndrome, acute coronary syndromes, Aged, Computed Tomography Angiography, Coronary Angiography, cvs, endocarditis, Female, France, Heart Failure, Humans, Incidence, Male, Middle Aged, Multidetector Computed Tomography, Prognosis, Prospective Studies, Risk Assessment, Risk Factors, Time Factors.

2016

Journal Article

  • Abdesselam, I, Dutour, A, Kober, F, Ancel, P, Bege, T, Darmon, P, Lesavre, N, Bernard, M & Gaborit, B 2016, “Time Course of Change in Ectopic Fat Stores After Bariatric Surgery”, Journal of the American College of Cardiology, vol. 67, no. 1, p. 117-119.

  • Bal-Theoleyre, L, Lalande, A, Kober, F, Giorgi, R, Collart, F, Piquet, P, Habib, G, Avierinos, J-F, Bernard, M, Guye, M & Jacquier, A 2016, “Aortic Function's Adaptation in Response to Exercise-Induced Stress Assessing by 1.5T MRI: A Pilot Study in Healthy Volunteers”, PloS One, vol. 11, no. 6, p. e0157704.
    Résumé : AIM: Evaluation of the aortic "elastic reserve" might be a relevant marker to assess the risk of aortic event. Our aim was to compare regional aortic elasticity at rest and during supine bicycle exercise at 1.5 T MRI in healthy individuals. METHODS: Fifteen volunteers (8 men), with a mean age of 29 (23-41) years, completed the entire protocol. Images were acquired immediately following maximal exercise. Retrospective cine sequences were acquired to assess compliance, distensibility, maximum rates of systolic distension and diastolic recoil at four different locations: ascending aorta, proximal descending aorta, distal descending aorta and aorta above the coeliac trunk level. Segmental aortic pulse wave velocity (PWV) was assessed by through plane velocity-encoded MRI. RESULTS: Exercise induced a significant decrease of aortic compliance and distensibility, and a significant increase of the absolute values of maximum rates of systolic distension and diastolic recoil at all sites (p<10-3). At rest and during stress, ascending aortic compliance was statistically higher compared to the whole descending aorta (p≤0.0007). We found a strong correlation between the rate pressure product and aortic distensibility at all sites (r = - 0.6 to -0.75 according to the site, p<10-4). PWV measured at the proximal and distal descending aorta increased significantly during stress (p = 0.02 and p = 0.008, respectively). CONCLUSION: Assessment of regional aortic function during exercise is feasible using MRI. During stress, aortic elasticity decreases significantly in correlation with an increase of the PWV. Further studies are required to create thresholds for ascending aorta dysfunction among patients with aneurysms, and to monitor the impact of medication on aortic remodeling.
    Mots-clés : Adaptation, Physiological, Adult, Aorta, Aorta, Thoracic, crmbm, cvs, Diastole, Elasticity, Exercise, Female, Healthy Volunteers, Humans, Magnetic Resonance Imaging, Male, Pilot Projects, Pulse Wave Analysis, Stress, Physiological, Supine Position, Systole, Vascular Stiffness.

  • Benyamine, A, Riccardi, F, Coze, S, Jacquier, A, Chaussenot, A, Paquis, V, Sallée, M, Aissi, K, Thuny, F, Frances, Y, Granel, B, Bauvois, A, Malezieux-Picard, A, Mourguet, M, Murarasu, A & Saada, N 2016, “[Sweet heart. Hypertrophic cardiomyopathy in a 49-year-old man]”, La Revue De Medecine Interne, vol. 37, no. 11, p. 779-781.
    Mots-clés : Cardiomyopathie hypertrophique, Cardiomyopathy, Hypertrophic, Humans, Hypertrophic cardiomyopathy, Male, MELAS syndrome, Middle Aged, Mitochondrial disorder, Mitochondriopathie, Syndrome MELAS.

  • Bière, L, Donal, E, Jacquier, A, Croisille, P, Genée, O, Christiaens, L, Prunier, F, Gueret, P, Boyer, L & Furber, A 2016, “A new look at left ventricular remodeling definition by cardiac imaging”, International Journal of Cardiology, vol. 209, p. 17-19.
    Mots-clés : Cardiac Imaging Techniques, Cardiac resynchronization therapy, CMR, echocardiography, Humans, Imaging, Left ventricular remodeling, Magnetic Resonance Imaging, Cine, Myocardial infarction, Ventricular Function, Left, Ventricular Remodeling.

  • Bricq, S, Frandon, J, Bernard, M, Guye, M, Finas, M, Marcadet, L, Miquerol, L, Kober, F, Habib, G, Fagret, D, Jacquier, A & Lalande, A 2016, “Semiautomatic detection of myocardial contours in order to investigate normal values of the left ventricular trabeculated mass using MRI”, Journal of magnetic resonance imaging: JMRI, vol. 43, no. 6, p. 1398-1406.
    Résumé : PURPOSE: To propose, assess, and validate a semiautomatic method allowing rapid and reproducible measurement of trabeculated and compacted left ventricular (LV) masses from cardiac magnetic resonance imaging (MRI). MATERIALS AND METHODS: We developed a method to automatically detect noncompacted, endocardial, and epicardial contours. Papillary muscles were segmented using semiautomatic thresholding and were included in the compacted mass. Blood was removed from trabeculae using the same threshold tool. Trabeculated, compacted masses and ratio of noncompacted to compacted (NC:C) masses were computed. Preclinical validation was performed on four transgenic mice with hypertrabeculation of the LV (high-resolution cine imaging, 11.75T). Then analysis was performed on normal cine-MRI examinations (steady-state free precession [SSFP] sequences, 1.5T or 3T) obtained from 60 healthy participants (mean age 49 ± 16 years) with 10 men and 10 women for each of the following age groups: [20,39], [40,59], and [60,79]. Interobserver and interexamination segmentation reproducibility was assessed by using Bland-Altman analysis and by computing the correlation coefficient. RESULTS: In normal participants, noncompacted and compacted masses were 6.29 ± 2.03 g/m(2) and 62.17 ± 11.32 g/m(2) , respectively. The NC:C mass ratio was 10.26 ± 3.27%. Correlation between the two observers was from 0.85 for NC:C ratio to 0.99 for end-diastolic volume (P < 10(-5) ). The bias between the two observers was -1.06 ± 1.02 g/m(2) for trabeculated mass, -1.41 ± 2.78 g/m(2) for compacted mass, and -1.51 ± 1.77% for NC:C ratio. CONCLUSION: We propose a semiautomatic method based on region growing, active contours, and thresholding to calculate the NC:C mass ratio. This method is highly reproducible and might help in the diagnosis of LV noncompaction cardiomyopathy. J. Magn. Reson. Imaging 2016;43:1398-1406.
    Mots-clés : cardiovascular magnetic resonance imaging, crmbm, cvs, left ventricle, noncompaction, papillary muscles, trabeculae.

  • Dehaene, A, Jacquier, A, Falque, C, Gorincour, G & Gaubert, JY 2016, “Imaging of acquired coronary diseases: From children to adults”, Diagnostic and Interventional Imaging, vol. 97, no. 5, p. 571-580.
    Résumé : Acquired coronary diseases include aneurysms, fistulae, dissections, and stenosis. Aneurysms may occur secondarily to Kawasaki disease, a childhood vasculitis, the prognosis of which depends on the coronary involvement, or they may be degenerative, infectious, inflammatory, or traumatic in origin. Fistulae develop between the coronary arterial system and a pulmonary or bronchial artery, or cardiac cavity. Dissections may occur spontaneously or may be post-traumatic. These coronary abnormalities may be found incidentally or may present as complications, infarction or rupture. The goals of this article are to understand acquired childhood and adult coronary diseases and their usual means of presentation, the ways of investigating them, and the principles of their treatment.
    Mots-clés : Adolescent, Adult, Aneurysm, Cardiac Imaging Techniques, Child, Child, Preschool, Computed Tomography Angiography, Coronary Angiography, Coronary artery, Coronary Disease, Dissection, echocardiography, Fistula, Humans, Image Enhancement, Image Interpretation, Computer-Assisted, Imaging, Three-Dimensional, Infant, Kawasaki, Magnetic Resonance Angiography, Risk Factors, Vasculitis, Young Adult.

  • Desmots, F, Fakhry, N, Mancini, J, Reyre, A, Vidal, V, Jacquier, A, Santini, L, Moulin, G & Varoquaux, A 2016, “Shear Wave Elastography in Head and Neck Lymph Node Assessment: Image Quality and Diagnostic Impact Compared with B-Mode and Doppler Ultrasonography”, Ultrasound in Medicine & Biology, vol. 42, no. 2, p. 387-398.
    Résumé : The aim of this study was to assess the diagnostic performance of shear wave elastography (SWE) in comparison to B-mode and Doppler ultrasonography in differentiating benign from malignant head and neck lymph nodes (HNLNs). Sixty-two HNLNs from 56 patients were prospectively examined using B-mode, Doppler and SWE. The standard of reference was histopathology or cytology and follow-up. Qualitative malignant criteria (hilum infiltration, cortical hypo-echogenicity, irregular margins, abnormal vessels) were assessed on a five-point scale. Four quantitative parameters were obtained: long axis length, short axis length, short axis/long axis ratio, resistive index and maximum shear elasticity modulus (μmax). Diagnostic performance was analyzed with special emphasis on the sub-centimeter HNLN subgroup. Thirty HNLNs were malignant (48%). μmax intra-observer reproducibility was 0.899 (0.728 in sub-centimeter subgroup). Malignant HNLNs were stiffer (μmax = 72.4 ± 59.0 kPa) compared with benign nodes (μmax = 23.3 ± 25.3 kPa) (p < 0.001). Among the quantitative criteria, μmax had the highest diagnostic accuracy (area under the curve = 0.903 ± 0.042), especially in the sub-centimeter subgroup (area under the curve = 0.929 ± 0.045; p < 0.001) in which the area under the curve was significantly higher compared with the other quantitative criteria (p < 0.05). The additional use of SWE combined with B-mode tended to improve diagnostic accuracy (p > 0.05). SWE is a promising reproducible quantitative tool with which to predict malignant HNLNs, especially sub-centimeter nodes.
    Mots-clés : Adolescent, Adult, Aged, Aged, 80 and over, Cervical lymph nodes, Diagnosis, Diagnosis, Differential, Elastic Modulus, Elasticity Imaging Techniques, Female, Hardness, Head and neck diseases, Humans, Image Enhancement, Image Interpretation, Computer-Assisted, Lymph Nodes, Lymphatic Diseases, Lymphatic Metastasis, Male, Middle Aged, Neck, Reproducibility of Results, Sensitivity and Specificity, Shear Strength, Shear wave elastography, Ultrasonography, Doppler, Ultrasound, Young Adult.

  • Dutour, A, Abdesselam, I, Ancel, P, Kober, F, Mrad, G, Darmon, P, Ronsin, O, Pradel, V, Lesavre, N, Martin, JC, Jacquier, A, Lefur, Y, Bernard, M & Gaborit, B 2016, “Exenatide decreases liver fat content and epicardial adipose tissue in patients with obesity and type 2 diabetes: a prospective randomized clinical trial using magnetic resonance imaging and spectroscopy”, Diabetes, Obesity & Metabolism, vol. 18, no. 9, p. 882-891.
    Résumé : AIM: To conduct a prospective randomized trial to investigate the effect of glucagon-like peptide-1 (GLP-1) analogues on ectopic fat stores. METHODS: A total of 44 obese subjects with type 2 diabetes uncontrolled on oral antidiabetic drugs were randomly assigned to receive exenatide or reference treatment according to French guidelines. Epicardial adipose tissue (EAT), myocardial triglyceride content (MTGC), hepatic triglyceride content (HTGC) and pancreatic triglyceride content (PTGC) were assessed 45 min after a standardized meal with 3T magnetic resonance imaging and proton magnetic resonance spectroscopy before and after 26 weeks of treatment. RESULTS: The study population had a mean glycated haemoglobin (HbA1c) level of 7.5 ± 0.2% and a mean body mass index of 36.1 ± 1.1 kg/m(2) . Ninety five percent had hepatic steatosis at baseline (HTGC ≥ 5.6%). Exenatide and reference treatment led to a similar improvement in HbA1c (-0.7 ± 0.3% vs. -0.7 ± 0.4%; p = 0.29), whereas significant weight loss was observed only in the exenatide group (-5.5 ± 1.2 kg vs. -0.2 ± 0.8 kg; p = 0.001 for the difference between groups). Exenatide induced a significant reduction in EAT (-8.8 ± 2.1%) and HTGC (-23.8 ± 9.5%), compared with the reference treatment (EAT: -1.2 ± 1.6%, p = 0.003; HTGC: +12.5 ± 9.6%, p = 0.007). No significant difference was observed in other ectopic fat stores, PTGC or MTGC. In the group treated with exenatide, reductions in liver fat and EAT were not associated with homeostatic model assessment of insulin resistance index, adiponectin, HbA1c or fructosamin change, but were significantly related to weight loss (r = 0.47, p = 0.03, and r = 0.50, p = 0.018, respectively). CONCLUSION: Our data indicate that exenatide is an effective treatment to reduce liver fat content and epicardial fat in obese patients with type 2 diabetes, and these effects are mainly weight loss dependent.
    Mots-clés : crmbm, cvs, epicardial adipose tissue, glucagon-like peptide 1 receptor agonist, hepatic triglyceride content, Magnetic Resonance Imaging, magnetic-resonance imaging, myocardial triglyceride content, Obesity, pancreatic triglyceride content, Proton Magnetic Resonance Spectroscopy, proton magnetic-resonance spectroscopy, type 2 diabetes.

  • Engblom, H, Tufvesson, J, Jablonowski, R, Carlsson, M, Aletras, AH, Hoffmann, P, Jacquier, A, Kober, F, Metzler, B, Erlinge, D, Atar, D, Arheden, H & Heiberg, E 2016, “A new automatic algorithm for quantification of myocardial infarction imaged by late gadolinium enhancement cardiovascular magnetic resonance: experimental validation and comparison to expert delineations in multi-center, multi-vendor patient data”, Journal of Cardiovascular Magnetic Resonance: Official Journal of the Society for Cardiovascular Magnetic Resonance, vol. 18, no. 1, p. 27.
    Résumé : BACKGROUND: Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) using magnitude inversion recovery (IR) or phase sensitive inversion recovery (PSIR) has become clinical standard for assessment of myocardial infarction (MI). However, there is no clinical standard for quantification of MI even though multiple methods have been proposed. Simple thresholds have yielded varying results and advanced algorithms have only been validated in single center studies. Therefore, the aim of this study was to develop an automatic algorithm for MI quantification in IR and PSIR LGE images and to validate the new algorithm experimentally and compare it to expert delineations in multi-center, multi-vendor patient data. METHODS: The new automatic algorithm, EWA (Expectation Maximization, weighted intensity, a priori information), was implemented using an intensity threshold by Expectation Maximization (EM) and a weighted summation to account for partial volume effects. The EWA algorithm was validated in-vivo against triphenyltetrazolium-chloride (TTC) staining (n = 7 pigs with paired IR and PSIR images) and against ex-vivo high resolution T1-weighted images (n = 23 IR and n = 13 PSIR images). The EWA algorithm was also compared to expert delineation in 124 patients from multi-center, multi-vendor clinical trials 2-6 days following first time ST-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) (n = 124 IR and n = 49 PSIR images). RESULTS: Infarct size by the EWA algorithm in vivo in pigs showed a bias to ex-vivo TTC of -1 ± 4%LVM (R = 0.84) in IR and -2 ± 3%LVM (R = 0.92) in PSIR images and a bias to ex-vivo T1-weighted images of 0 ± 4%LVM (R = 0.94) in IR and 0 ± 5%LVM (R = 0.79) in PSIR images. In multi-center patient studies, infarct size by the EWA algorithm showed a bias to expert delineation of -2 ± 6 %LVM (R = 0.81) in IR images (n = 124) and 0 ± 5%LVM (R = 0.89) in PSIR images (n = 49). CONCLUSIONS: The EWA algorithm was validated experimentally and in patient data with a low bias in both IR and PSIR LGE images. Thus, the use of EM and a weighted intensity as in the EWA algorithm, may serve as a clinical standard for the quantification of myocardial infarction in LGE CMR images. CLINICAL TRIAL REGISTRATION: CHILL-MI: NCT01379261 . MITOCARE: NCT01374321 .
    Mots-clés : Automatic quantification algorithm, cvs, Expectation maximization, Experimental validation, LGE CMR, Multi-center patient data.

  • Izaaryene, J, Saeed Kilani, M, Rolland, P-H, Gaubert, J-Y, Jacquier, A, Bartoli, J-M & Vidal, V 2016, “Preclinical study on an animal model of a new non-adhesive cyanoacrylate (Purefill®) for arterial embolization”, Diagnostic and Interventional Imaging, vol. 97, no. 11, p. 1109-1116.
    Résumé : PURPOSE: The goal of this study was to assess the distal dispersion, the adhesion strength to catheter, the vascular toxicity and the ability in excluding embolized vessels using Purefill® (α-hexil-cyanoacrylate) as embolic material, which is a new high purity cyanoacrylate and compare these results with those obtained with N-butyl-2-cyanoacrylate (Histoacryl®) and a mixture of N-butyl-2-cyanoacrylate and methacryloxysulfolane. MATERIAL AND METHODS: In six pigs, the right rete mirabile (RM) and right renal arteries were embolized with α-hexil-cyanoacrylate, and the left rete mirabile and left renal artery were embolized with N-butyl-2-cyanoacrylate and N-butyl-2-cyanoacrylate+Methacryloxysulfolane for comparison. One minute after glue injection through the microcatheter, displacements of the kidney and the pharyngeal artery were measured on angiographic images, before exercising any traction and during catheter pulling, when the forces were maximal. Displacement was measured in terms of distance (mm) with respect to renal pedicles and in terms of angle (°) with respect to the rete. After acute embolization (4 pigs) or three-month follow-up (2 pigs), the kidneys and the RM were removed and further analysed using computed tomography and histopathological examination. RESULTS: Similar short and long-term embolic efficacies were observed with the three glues. The mean displacement distances of renal pedicles were 2.6mm for α-hexil-cyanoacrylate, 22.6mm for N-butyl-2-cyanoacrylate and 19.8mm for N-butyl-2-cyanoacrylate+Methacryloxysulfolane (P=0.021). The mean angles of displacement of the ascending pharyngeal arteries were for 12.2° for α-hexil-cyanoacrylate, 23.5° for N-butyl-2-cyanoacrylate and 30° for N-butyl-2-cyanoacrylate+Methacryloxysulfolane (P=0.070). Histopathologically, findings were similar for the three glues, immediately and 90 days after embolization. CONCLUSION: α-hexil-cyanoacrylate has occlusive efficacy in the short and long term similar to those of N-butyl-2-cyanoacrylate and N-butyl-2-cyanoacrylate+Methacryloxysulfolane. In addition, histopathological changes are similar with the three glues immediately or 90 days after embolization. Conversely, α-hexil-cyanoacrylate results in a reduced angle and distance of displacement compared to the other two glues, assumably reflecting a limited adhesive strength.
    Mots-clés : Animals, Arterial embolization, Cyanoacrylate, Cyanoacrylates, Disease Models, Animal, Embolic material, Embolization, Therapeutic, Interventional radiology, Kidney, Purefill, Renal Artery, Swine, Treatment Outcome.

  • Rouabah, K, Varoquaux, A, Caporossi, JM, Louis, G, Jacquier, A, Bartoli, JM, Moulin, G & Vidal, V 2016, “Image fusion-guided portal vein puncture during transjugular intrahepatic portosystemic shunt placement”, Diagnostic and Interventional Imaging, vol. 97, no. 11, p. 1095-1102.
    Résumé : PURPOSE: The purpose of this study was to assess the feasibility and utility of image fusion (Easy-TIPS) obtained from pre-procedure CT angiography and per-procedure real-time fluoroscopy for portal vein puncture during transjugular intrahepatic portosystemic shunt (TIPS) placement. MATERIALS AND METHODS: Eighteen patients (15 men, 3 women) with a mean age of 63 years (range: 48-81 years; median age, 65 years) were included in the study. All patients underwent TIPS placement by two groups of radiologists (one group with radiologists of an experience<3 years and one with an experience≥3 years) using fusion imaging obtained from three-dimensional computed tomography angiography of the portal vein and real-time fluoroscopic images of the portal vein. Image fusion was used to guide the portal vein puncture during TIPS placement. At the end of the procedure, the interventional radiologists evaluated the utility of fusion imaging for portal vein puncture during TIPS placement. Mismatch between three-dimensional computed tomography angiography and real-time fluoroscopic images of the portal vein on image fusion was quantitatively analyzed. Posttreatment CT time, number of the puncture attempts, total radiation exposure and radiation from the retrograde portography were also recorded. RESULTS: Image fusion was considered useful for portal vein puncture in 13/18 TIPS procedures (72%). The mean posttreatment time to obtain fusion images was 16.4minutes. 3D volume rendered CT angiography images was strictly superimposed on direct portography in 10/18 procedures (56%). The mismatch mean value was 0.69cm in height and 0.28cm laterally. A mean number of 4.6 portal vein puncture attempts was made. Eight patients required less than three attempts. The mean radiation dose from retrograde portography was 421.2dGy.cm2, corresponding to a mean additional exposure of 19%. CONCLUSION: Fusion imaging resulting from image fusion from pre-procedural CT angiography is feasible, safe and makes portal puncture easier during TIPS placement.
    Mots-clés : Aged, Aged, 80 and over, Computed Tomography Angiography, Esophageal and Gastric Varices, Feasibility Studies, Female, Fluoroscopy, Humans, Image fusion, Image Processing, Computer-Assisted, Imaging guidance, Imaging, Three-Dimensional, Interventional imaging, Liver Cirrhosis, Male, Middle Aged, Portal Vein, Portasystemic Shunt, Transjugular Intrahepatic, Portography, Punctures, Surgery, Computer-Assisted, Transjugular intrahepatic portosystemic shunt (TIPS).

  • Sorensen, C, Dabadie, A, Pico, H, Gach, P, Dehaene, A, Gaubert, J-Y, Jacquier, A, Petit, P & Gorincour, G 2016, “Cardiac imaging: From fetus to adult”, Diagnostic and Interventional Imaging, vol. 97, no. 5, p. 503-504.

  • Vaillant, M, Bartoli, MA, Soler, R, Barral, P-A, Jacquier, A, Sarlon Bartoli, G & Magnan, P-E 2016, “Emergency Embolization of a Ruptured Aneurysm of the Internal Iliac Artery by Direct Ultrasound-Guided Puncture: Report of a Case”, Annals of Vascular Surgery, vol. 31, p. 205.e1-4.
    Résumé : We report the emergency embolization of a ruptured aneurysm of the internal iliac artery in a patient at high surgical risk. Admission computed tomography scan showed that the ostium of the aneurysmal internal iliac artery was covered by a covered stent. In this patient, we chose to carry out an embolization of the aneurysm and its efferent arteries by direct puncture of the aneurysmal sac using an antero-external abdominal approach under ultrasound guidance. Short-term results were favorable and we consider that this technique is one of the therapeutic options to discuss in such situation.
    Mots-clés : Aged, 80 and over, Aneurysm, Ruptured, Embolization, Therapeutic, Emergencies, Humans, Iliac Aneurysm, Iliac Artery, Male, Punctures, Tissue Adhesives, Tomography, X-Ray Computed, Treatment Outcome, Ultrasonography, Interventional.

2015

Journal Article


  • Capron, T, Troalen, T, Robert, B, Jacquier, A, Bernard, M & Kober, F 2015, “Myocardial perfusion assessment in humans using steady-pulsed arterial spin labeling”, Magnetic Resonance in Medicine, vol. 74, no. 4, p. 990-998, viewed 5October,2015, .
    Résumé : Purpose Although arterial spin labeling (ASL) has become a routinely performed method in the rodent heart, its application to the human heart remains challenged by low tissue blood flow and cardiac and respiratory motion. We hypothesized that an alternative steady-pulsed ASL (spASL) method would provide more efficient perfusion signal averaging by driving the tissue magnetization into a perfusion-dependent steady state. Methods We evaluated the feasibility of spASL in the human heart by combining pulsed labeling in the aortic root with a balanced steady state free precession sequence. The spASL scheme was applied to 13 subjects under free breathing. Breathing motion was addressed using retrospective image exclusion based on a contour-based cross-correlation algorithm. Results The measured signal with spASL was due to labeled blood. We found that the perfusion signal was larger than that obtained with the earlier flow-sensitive alternating inversion recovery (FAIR) method. Averaged myocardial blood flow (MBF) over four myocardial regions was 1.28 ± 0.36 mL·g−1·min−1. Conclusion spASL was able to quantify MBF in healthy subjects under free breathing. Because quantification with ASL is more direct than with first-pass perfusion MRI, it appears particularly suited for pathologies with diffuse microvascular alterations, MBF reserve, and follow-up studies. Magn Reson Med 74:990–998, 2015. © 2014 Wiley Periodicals, Inc.
    Mots-clés : arterial spin labeling, Blood Flow, cine-ASL, crmbm, cvs, myocardial perfusion, steady state, steady-pulsed.

  • Gaborit, B, Abdesselam, I, Kober, F, Jacquier, A, Ronsin, O, Emungania, O, Lesavre, N, Alessi, M-C, Martin, JC, Bernard, M & Dutour, A 2015, “Ectopic fat storage in the pancreas using 1H-MRS: importance of diabetic status and modulation with bariatric surgery-induced weight loss”, International Journal of Obesity (2005), vol. 39, no. 3, p. 480-487.
    Résumé : OBJECTIVES: Recent literature suggests that ectopic fat deposition in the pancreas may contribute to endocrine and exocrine organ dysfunction, such as type 2 diabetes (T2D), pancreatitis or pancreatic cancer. The aim of this study was to determine factors associated with pancreatic triglyceride content (PTGC), and to investigate the impact of bariatric surgery on ectopic fat pads, pancreatic fat (PTGC) and hepatic fat (HTGC). SUBJECTS: In all, 45 subjects (13 lean, 13 obese nondiabetics and 19 T2D, matched for age and gender) underwent 1H-magnetic resonance spectroscopy, computed tomography of the visceral abdominal fat, metabolic and lipidomic analysis, including insulin-resistance homeostasis model assessment (HOMA-IR), insulin-secretion homeostasis model assessment (HOMA-B) and plasma fatty-acid composition. Twenty obese subjects were reassessed 6 months after the bariatric surgery. RESULTS: PTGC was significantly higher in type 2 diabetic subjects (23.8±3.2%) compared with obese (14.0±3.3; P=0.03) and lean subjects (7.5±0.9%; P=0.0002). PTGC remained significantly associated with T2D after adjusting for age and sex (β=0.47; P=0.004) or even after adjusting for waist circumference, triglycerides and HOMA-IR (β=0.32; P=0.04). T2D, C18:1n-9 (oleic acid), uric acid, triglycerides and plasminogen activator inhibitor-1 were the five more important parameters involved in PTGC prediction (explained 80% of PTGC variance). Bariatric surgery induced a huge reduction of both HTGC (-51.2±7.9%) and PTGC (-43.8±7.0%) reaching lean levels, whereas body mass index remained greatly elevated. An improvement of insulin resistance HOMA-IR and no change in HOMA-B were observed after bariatric surgery. The PTGC or HTGC losses were not correlated, suggesting tissue-specific mobilization of these ectopic fat stores. CONCLUSION: Pancreatic fat increased with T2D and drastically decreased after the bariatric surgery. This suggests that decreased PTGC may contribute to improved beta cell function seen after the bariatric surgery. Further, long-term interventional studies are warranted to examine this hypothesis and to determine the degree to which ectopic fat mobilization may mediate the improvement in endocrine and exocrine pancreatic functions.
    Mots-clés : crmbm, cvs.

  • Saeed Kilani, M, Izaaryene, J, Cohen, F, Varoquaux, A, Gaubert, JY, Louis, G, Jacquier, A, Bartoli, JM, Moulin, G & Vidal, V 2015, “Ethylene vinyl alcohol copolymer (Onyx®) in peripheral interventional radiology: indications, advantages and limitations”, Diagnostic and Interventional Imaging, vol. 96, no. 4, p. 319-326.
    Résumé : Onyx(®) is a remarkable liquid embolizing agent that may allow a well-trained operator to undertake challenging embolization procedures. In multiple interventional radiology indications, the physico-chemical properties of Onyx(®) allow safe embolization. The purpose of this article is to review the advantages and disadvantages of Onyx(®) and identify its main indications.
    Mots-clés : AVM, cvs, Embolization, Embolization, Therapeutic, Ethylene vinyl alcohol copolymer, Humans, Onyx(®), Polyvinyls, Radiology, Interventional, Type II endoleak.

  • Simonnet, B, Jacquier, A, Salaun, E, Hubert, S & Habib, G 2015, “Cardiac involvement in hypereosinophilic syndrome: role of multimodality imaging”, European Heart Journal Cardiovascular Imaging, vol. 16, no. 2, p. 228.

  • Tavano, A, Maurel, B, Gaubert, J-Y, Varoquaux, A, Cassagneau, P, Vidal, V, Bartoli, J-M, Moulin, G & Jacquier, A 2015, “MR imaging of arrhythmogenic right ventricular dysplasia: What the radiologist needs to know”, Diagnostic and Interventional Imaging, vol. 96, no. 5, p. 449-460.
    Résumé : Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is an inherited heart muscle disease that predominantly affects the right ventricle. Clinical manifestations are related to severe ventricular arrhythmia that may lead to sudden death, mostly in young patients. Magnetic resonance imaging (MRI), included in the new diagnostic criteria since 2010, aims to detect segmental and global wall motion abnormalities, reduced ejection fraction, right ventricular dilatation and right ventricular diastolic/systolic dysfunction. An MRI assessment of the right ventricle is often challenging, partly because the MRI diagnostic criteria have some limitations, and also because it requires a significant learning curve due to the low prevalence of the disease. Therefore, this article aims to review the pathophysiology of the disease, the cardiac MRI protocol, images of the various stages of this affection as well as the differential diagnosis.
    Mots-clés : Adult, Arrhythmogenic right ventricular dysplasia, Cardiac Imaging Techniques, Cardiac MRI, Child, Diagnosis, Differential, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Radiology.

2014

Journal Article

  • Bernard, M, Jacquier, A & Kober, F 2014, “Cardiovascular magnetic resonance in ischemic heart disease”, Future Cardiology, vol. 10, no. 4, p. 487-496.
    Résumé : Ischemic heart disease is the major cause of death in developed countries. Recently, cardiovascular magnetic resonance (CMR) has appeared as a powerful technique for diagnosis and prognosis of ischemia, as well as for postischemic therapy follow-up. The objective of this chapter is to provide an overview of the role of CMR in assessing ischemic myocardium. It reviews the most recent studies in this field and includes CMR parameters that are already well established in the clinical setting as well as promising or emerging parameters in clinical use.
    Mots-clés : crmbm.

  • Caporossi, J-M, Vidal, V, Jacquier, A, Reyre, A, Flavian, A, Muller, C, Gaubert, J-Y, Bartoli, J-M, Moulin, G & Varoquaux, A 2014, “Balloon occlusion versus wedged hepatic venography using iodinated contrast for targeting the portal vein during TIPS”, Diagnostic and Interventional Imaging.
    Résumé : PURPOSE: To assess the efficacy, safety and gain in procedure time of the technique of balloon occlusion hepatic venography with iodinated contrast used to target the portal vein during TIPS. The technique is assessed versus wedged hepatic venography. MATERIALS AND METHODS: Fifty-eight TIPS were prospectively included. The portal vein was located in 30 cases by the wedged hepatic venography (group 1) and in 28 cases by balloon occlusion hepatic venography (group 2). To compare both techniques a "portogram quality" score was defined using a 5 points scale. The time required to achieve portal puncture was also recorded. The complications of both procedures were assessed and classified in groups as intrahepatic hematoma or intraperitoneal hemorrhage. RESULTS: The right portal vein was visualized in a significantly higher number of patients using balloon than with wedged retrograde venography 71.3% (20/28) versus 13.3% (4/30) respectively (P=0.002). The quality score for the portogram was significantly higher for balloon hepatic venography 2.21 than for wedged hepatic venography 1.07 (P=0.002). The mean time required to puncture the portal vein was significantly shorter when the right branch of the portal vein was visualized 21min versus 33.5min (P=0.046). We recorded one intrahepatic hematoma (3.3%) and 4 intraperitoneal hemorrhage (13.3%) secondary to wedged hepatic venography. There were no complications with balloon occlusion hepatic venography (P=0.053). CONCLUSION: The use of balloon occlusion hepatic venography improves the quality of the retrograde portal venography to target the portal vein and decreases procedure time. The balloon technique is also burdened with fewer complications than the standard wedged hepatic venography.

  • Grob, A, Thuny, F, Villacampa, C, Flavian, A, Gaubert, JY, Raoult, D, Casalta, JP, Habib, G, Moulin, G & Jacquier, A 2014, “Cardiac multidetector computed tomography in infective endocarditis: a pictorial essay”, Insights into Imaging, vol. 5, no. 5, p. 559-570.
    Résumé : OBJECTIVES: The goals of this pictorial essay are: (1) to set out a multislice computed tomography (MSCT) imaging protocol to assess infective endocarditis (IE); (2) to give an MSCT overview of valvular and peri-valvular involvement during IE; (3) to give a CT overview of septic embolism and infectious pseudoaneurysms during IE. METHODS: MSCT acquisition protocols to assess IE are performed in two different phases: the first acquisition, under electrocardiography (ECG) gating, covers the cardiac structures during first-pass iodine injection; the second acquisition covers the thorax, abdomen, pelvic and cerebral regions. RESULTS: Valvular and peri-valvular lesions during IE are: vegetation-a hypodense, homogeneous, irregular mass on a valve or endocardial structure; perforation-a defect in the leaflet; valvular aneurysm-loss of the homogenous curvature of the leaflet; valvular thickening; peri-valvular abscess; pseudoaneurysm; fistula and disinsertion of a prosthetic valve. Extra-cardiac location could involve all organs. CONCLUSIONS: MSCT can be considered as a useful complement in visualising the cardiac lesions of IE if echocardiography is inconclusive. MSCT is the only imaging modality that provides assessment of valvular and peri-valvular involvement, extra-cardiac lesions, and non-invasive evaluation of the coronary artery anatomy, simultaneously. MAIN MESSAGES: • MSCT provides assessment of coronary anatomy, cardiac and extra-cardiac lesions. • MSCT represents an alternative to echocardiography during IE. • Surgical valve replacement is usually required if vegetation is >10 mm. • Peri-valvular extension (abscesses, pseudoaneurysm and fistulae) required surgical treatment.

  • Jacquier, A, Kallifatidis, A, Guibert, N, Giorgi, R, Falque, C, Thuny, F, Croisille, P, Clarysse, P, Maurel, B, Flavian, A, Gaubert, J-Y, Moulin, G & Habib, G 2014, “Assessment of myocardial partition coefficient of gadolinium (λ) in dilated cardiomyopathy and its impact on segmental and global systolic function”, Journal of magnetic resonance imaging: JMRI, vol. 40, no. 6, p. 1336-1341.
    Résumé : PURPOSE: 1) To assess the myocardial partition coefficient (λ) of gadolinium quantified using T1 mapping in dilated cardiomyopathy (DCM); and 2) to assess the impact of increased λ on left ventricular (LV) circumferential strain and ejection fraction in DCM. MATERIALS AND METHODS: Seventeen patients with DCM and 11 controls were prospectively included. All patients and controls underwent a 1.5T MRI using: 1) cine to quantify LV volumes and function; 2) tagging to quantify circumferential strain in mid-LV; 3) T1 mapping before and 9 minutes after contrast injection to quantify R1 , ΔR1 , and λ; and 4) inversion recovery 3D Flash was used to assess late gadolinium enhancement (LGE) 10 minutes after Gd DOTA injection (0.2 mmol/kg). We used Student's t-test to compare means, Pearson's test for correlation assessment, and a mixed linear model to integrate the dependency between myocardial segments. RESULTS: No difference in median λ was measured between patients with (0.52 [interquartile range = 0.48-0.56]) and without enhancement on LGE (0.51 [0.47-0.54]; P = 0.07). Circumferential strain value measured in each segment was correlated with the λ measured in the corresponding segment (r = 0.55; P < 0.0001). Multivariate analysis revealed a significant link between the λ in each segment and circumferential strain (0.002 ± 0.001; P = 0.009) and also with ejection fraction (-0.001 ± 0.0008; P = 0.04). CONCLUSION: In DCM, λ correlates independently with circumferential strain and ejection fraction, suggesting that there is a link between λ and systolic function.J. Magn. Reson. Imaging 2014;40:1336-1341. © 2013 Wiley Periodicals, Inc.

  • Quatre, A, Jacquier, A, Petit, P, Giorgi, R & Thuret, I 2014, “MRI monitoring of myocardial iron overload: use of cardiac MRI combined with hepatic MRI in a cohort of multi-transfused patients with thalassaemia”, Diagnostic and Interventional Imaging, vol. 95, no. 11, p. 1065-1069.
    Résumé : PURPOSE: We report the results of combining cardiac and hepatic MRI in the same examination to monitor 48 multi-transfused patients presenting iron overload secondary to their transfusions. This cardiac MRI technique uses acquisition sequences and calculation software that are readily available for 1.5 T systems, and it has been validated to screen for patients at risk of cardiac complications who present myocardial iron overload (T2*<20milliseconds). PATIENTS AND METHODS: A total of 176 combined MRI examinations were performed between May 2006 and January 2012 in 48 patients who had received transfusions due to thalassaemia. This monocentric retrospective study brings together all of the imaging examinations carried out. RESULTS: There was a positive correlation between the cardiac T2* values and left ventricular ejection fraction, which were measured in the same examination. At the first assessment 23/48 patients had a T2*<20ms. These patients showed a significant improvement in cardiac T2* over time while their iron chelation therapy was being intensified. CONCLUSION: This study validates the application of the cardiac MRI technique used to monitor cardiac iron overload in patients who have undergone multiple transfusions.

  • Theron, A, Jacquier, A, Ravis, E, Ronchard, T, Gaubert, J-Y, Grisoli, D, Gariboldi, V & Collart, F 2014, “Role of three-dimensional transesophageal echocardiography in diagnosis of coronary anomalies”, Echocardiography (Mount Kisco, N.Y.), vol. 31, no. 10, p. E317-318.

2013

Journal Article


  • Thuny, F, Gaubert, J-Y, Jacquier, A, Tessonnier, L, Cammilleri, S, Raoult, D & Habib, G 2013, “Imaging investigations in infective endocarditis: Current approach and perspectives”, Archives of Cardiovascular Diseases, vol. 106, no. 1, p. 52-62, viewed 3June,2014, .
    Résumé : Summary Infective endocarditis is a serious disease that needs rapid diagnosis and accurate risk stratification to offer the best therapeutic strategy. Echocardiography plays a key role in the management of the disease but may be limited in some clinical situations. Moreover, this method is insensitive for very early detection of the infection and assessment of therapeutic response because it does not provide imaging at the molecular and cellular levels. Recently, several novel morphological, molecular and hybrid imaging modalities have been investigated in infective endocarditis and offer new perspectives for better management of the disease.
    Mots-clés : computed tomography, Échocardiographie, echocardiography, Endocardite, endocarditis, Imagerie, Imagerie par résonance magnétique nucléaire, Imaging, Magnetic Resonance Imaging, Positron emission tomography, Tomodensitométrie, Tomographie par émission de positons.

2012

Journal Article

  • Amabile, N, Jacquier, A, Shuhab, A, Gaudart, J, Bartoli, J-M, Paganelli, F & Moulin, G 2012, “Incidence, predictors, and prognostic value of intramyocardial hemorrhage lesions in ST elevation myocardial infarction”, Catheterization and cardiovascular interventions: official journal of the Society for Cardiac Angiography & Interventions, vol. 79, no. 7, p. 1101-1108.
    Résumé : BACKGROUND: Intra myocardial hemorrhage lesions (IMH) are underdiagnosed complication of ST elevation myocardial infarction (STEMI). We sought to determine the incidence, predictors and the prognostic value of IMH in STEMI using cardiac MR imaging (CMR) techniques. METHODS: We screened for inclusion consecutive patients with STEMI treated by percutaneous coronary intervention (PCI) within the first 12 hr of evolution. IMH lesions were identified on T2-weighted sequences on CMR between days 4 and 8 after PCI. Adverse cardiac events were defined as a composite of death + severe ventricular arrhythmias + acute coronary syndrome + acute heart failure. RESULTS: N = 114 patients were included and n = 11 patients (10%) presented IMH lesions. Patients with IMH lesions had a larger myocardial infarction extent (25.6 ± 1.8 vs. 13.5 ± 1.0 % LV mass, P < 0.01), microvascular obstructive lesions extent (4.6 ± 1.0 vs. 1.3 ± 0.3% LV mass, P < 0.01) and lower LV ejection fraction (40.7 ± 2.3% vs. 50.7 ± 1.3%, P < 0.01). The value of glycemia at admission was an independent predictor of IMH development (Odd ratio 1.8 [1.1-2.8] per mmol l(-1), P = 0.01). The incidence of adverse cardiac events was higher in the IMH group than in the non-IMH group during the first year following STEMI (P = 0.01, log-rank analysis). Cox regression analysis identified the presence of IMH lesions as an independent predictor of adverse clinical outcome (Hazard Ratio = 2.8 [1.2-6.8], P = 0.02). CONCLUSION: Our study indicates that IMH is a rare but severe finding in STEMI, associated with a larger myocardial infarction and a worse clinical outcome. Per-PCI glycemia might influence IMH development.
    Mots-clés : Angioplasty, Balloon, Coronary, Cardiovascular Diseases, Chi-Square Distribution, France, Hemorrhage, Hyperglycemia, Incidence, Kaplan-Meier Estimate, Logistic Models, Magnetic Resonance Imaging, Cine, Multivariate Analysis, Myocardial infarction, Myocardium, Odds Ratio, Predictive Value of Tests, Proportional Hazards Models, Risk Assessment, Risk Factors.

  • Bun, S-S, Kober, F, Jacquier, A, Espinosa, L, Kalifa, J, Bonzi, M-F, Kopp, F, Lalevee, N, Zaffran, S, Deharo, J-C, Cozzone, PJ & Bernard, M 2012, “Value of in vivo T2 measurement for myocardial fibrosis assessment in diabetic mice at 11.75 T”, Investigative radiology, vol. 47, no. 5, p. 319-323.
    Résumé : OBJECTIVE: The aim of the study was to assess the value of in vivo T2 measurements to noninvasively quantify myocardial fibrosis in diabetic mice at 11.75 T. Diabetic cardiomyopathy is characterized by extracellular matrix alteration and microcirculation impairment. These conditions might provide electrical heterogeneity, which is a substrate for arrhythmogenesis. T1 mapping has been proposed to quantify diffuse myocardial fibrosis in cardiac diseases but has several limitations. T2 measurement may represent an alternative for fibrosis quantification at high magnetic field. MATERIALS AND METHODS: A magnetic resonance imaging protocol including in vivo T2 measurements at 11.75 T was performed in 9 male C57BL/6J mice after 8 weeks of streptozotocin-induced diabetes and in 9 control mice. Programmed ventricular stimulation was performed in both groups. T2 measurements were compared with histologic quantification of fibrosis using picrosirius red staining. RESULTS: Myocardial T2 was significantly lower in diabetic mice (13.8 ± 2.8 ms) than in controls (18.9 ± 2.3 ms, P < 0.001). There was a good correlation between T2 and fibrosis area obtained by histopathology (R = 0.947, P < 0.001). During programmed ventricular stimulation, 3 nonsustained ventricular tachycardias were induced in diabetic mice versus none in the control group. CONCLUSIONS: The in vivo T2 relaxation time strongly correlated with myocardial fibrosis area assessed with histologic staining in diabetic mice.
    Mots-clés : Animals, crmbm, Diabetes Mellitus, Experimental, Endomyocardial Fibrosis, Magnetic Resonance Imaging, Male, Mice, Mice, Inbred C57BL, Reproducibility of Results, Sensitivity and Specificity, Streptozocin.
    Note Note
    The following values have no corresponding Zotero field:<br/>Author Address: Centre de Resonance Magnetique Biologique et Medicale-UMR 6612 CNRS, Universite de la Mediterranee, Faculte de Medecine, Marseille, France. sithi.bun@gmail.com<br/>ET - 2012/04/11<br/>
    Note Note
    <p>Bun, Sok-Sithikun <br />Kober, Frank <br />Jacquier, Alexis <br />Espinosa, Leon <br />Kalifa, Jerome <br />Bonzi, Marie-France <br />Kopp, Francis <br />Lalevee, Nathalie <br />Zaffran, Stephane <br />Deharo, Jean-Claude <br />Cozzone, Patrick J <br />Bernard, Monique <br />Research Support, Non-U.S. Gov't <br />United States <br />Investigative radiology <br />Invest Radiol. 2012 May;47(5):319-23. doi: 10.1097/RLI.0b013e318243e062.</p>

  • Cassagneau, P, Jacquier, A, Giorgi, R, Amabile, N, Gaubert, J-Y, Cohen, F, Muller, C, Jolibert, M, Louis, G, Varoquaux, A, Vidal, V, Bartoli, J-M & Moulin, G 2012, “Prognostic value of preoperative coronary computed tomography angiography in patients treated by orthotopic liver transplantation”, European journal of gastroenterology & hepatology, vol. 24, no. 5, p. 558-562.
    Résumé : OBJECTIVES: The aim of this study was to assess the feasibility of 64-slice coronary computed tomography (CT) angiography in patients treated by orthotopic liver transplantation, and to compare prognostic values of CT angiography and dobutamine stress echocardiography in the same population. METHODS: Eighty-two consecutive patients, without known coronary artery disease, who underwent orthotopic liver transplantation, were included in this study. A CT angiography was performed along with usual explorations including dobutamine stress echography. A one-year minimal follow-up was performed to seek cardiac events. RESULTS: Fifty-two (65.8%) patients underwent a CT angiography. Thirty-seven (71%) were totally normal or showed nonobstructive coronary plaque, six (12%) showed at least one obstructive coronary plaque greater than 50%. Nine (17%) of the examined patients had at least one nonassessable segment. A total of six (7.6%) major cardiac events occurred in a mean-time follow-up of 17.8 ± 12.7 months. CONCLUSION: CT angiography that is normal or with a nonobstructive coronary plaque has a negative predicting value of 95% [0.82-0.99] for major cardiac adverse events, and of 100% [0.91-1] for clinical coronary events in patients undergoing orthotopic liver transplantation. The prognostic value of CT angiography was comparable with that of dobutamine stress echography.
    Mots-clés : Coronary Angiography, Coronary Artery Disease, Echocardiography, Stress, Feasibility Studies, Liver Diseases, Liver Transplantation, Predictive Value of Tests, Tomography, X-Ray Computed.

  • Daumas, A, Rossi, P, Jacquier, A & Granel, B 2012, “Myopericarditis revealing giant cell arteritis in the elderly”, The Journal of rheumatology, vol. 39, no. 3, p. 665-666.
    Mots-clés : Acute Disease, Aged, Biopsy, Comorbidity, echocardiography, Electrocardiography, Giant Cell Arteritis, Humans, Magnetic Resonance Imaging, Male, Myocarditis, Temporal Arteries.

  • Flavian, A, Carta, F, Thuny, F, Bernard, M, Kober, F, Moulin, G, Varoquaux, A & Jacquier, A 2012, “Cardiac MRI in the diagnosis of complications of myocardial infarction”, Diagnostic and interventional imaging, vol. 93, no. 7-8, p. 578-585.
    Résumé : The improvement in revascularization techniques and medicine treatment during infarction has substantially reduced mortality during the acute phase of this condition. Since the advent of kinetic sequences and the concomitant development of gadolinium chelates and delayed enhancement sequences, cardiac MRI has become the second-line reference examination for ischemic heart disease. The technique of delayed enhancement with the inversion recovery sequence performed after injection has been validated for numerous indications in ischemic disease. Delayed enhancement sequences make it possible in particular to look for "no-reflow" areas (microvascular obstructions), to quantify the infarction area, and to assess prognosis. MRI also allows us to define the area at risk, that is, the area with edema, and to look for and assess the mechanical complications of the infarction. The aim of this review is to summarize current knowledge about: the pharmacokinetic principles that regulate myocardial enhancement; the different sequences available to acquire delayed enhancement images, and; the value of cardiac MRI in the diagnosis of complications of myocardial infarction.
    Mots-clés : Cardiac Imaging Techniques, crmbm, Heart Diseases, Humans, Magnetic Resonance Imaging, Myocardial infarction.

  • Gaborit, B, Kober, F, Jacquier, A, Moro, PJ, Cuisset, T, Boullu, S, Dadoun, F, Alessi, M-C, Morange, P, Clément, K, Bernard, M & Dutour, A 2012, “Assessment of epicardial fat volume and myocardial triglyceride content in severely obese subjects: relationship to metabolic profile, cardiac function and visceral fat”, International journal of obesity (2005), vol. 36, no. 3, p. 422-430.
    Résumé : OBJECTIVE: To assess epicardial fat volume (EFV), myocardial TG content (MTGC) and metabolic profile in severely obese patients, and to determine whether ectopic fat depots are linked to metabolic disorders or myocardial function. RESEARCH DESIGN AND METHODS: Sixty-three subjects with normal LV function and no coronary artery disease, including 33 lean (BMI: 21.4 ± 2.0 kg m(-2)) and 30 obese (BMI: 41.8 ± 6 kg m(-2)) patients, underwent 3-T cardiovascular MRI, and anthropometric, biological and visceral abdominal fat (VAT) assessments. EFV was measured by short-axis slice imaging and myocardial (intra-myocellular) TG content was measured by proton magnetic resonance spectroscopy. RESULTS: EFV and MTGC were positively correlated (r=0.52, P<0.0001), and were both strongly correlated with age, BMI, waist circumference and VAT, but not with severity of obesity. EFV and MTGC were significantly higher in obese patients than in lean controls (141 ± 18 versus 79 ± 7 ml, P=0.0001; 1.0 ± 0.1 versus 0.6 ± 0.1%, P=0.01, respectively), but some differences were found between the two cardiac depots: EFV was higher in diabetic obese subjects as compared with that in non-diabetic obese subjects (213 ± 34 versus 141 ± 18 ml, P=0.03), and was correlated with parameters of glucose tolerance (fasting plasma glucose, insulin and HOMA-IR), whereas MTGC was not. EFV and MTGC were both associated with parameters of lipid profile or inflammation (TGs, CRP). Remarkably, this was VAT-dependent, as only VAT remained independently associated with metabolic parameters (P<0.01). Concerning myocardial function, MTGC was the only parameter independently associated with stroke volume (β=-0.38, P=0.01), suggesting an impact of cardiac steatosis in cardiac function. CONCLUSIONS: These data show that VAT dominates the relationship between EFV, MTGC and metabolic measures, and uncover specific partitioning of cardiac ectopic lipid deposition.
    Mots-clés : Adult, crmbm, Diabetes Mellitus, Type 2, Female, Humans, Intra-Abdominal Fat, Lipid Metabolism, Magnetic Resonance Spectroscopy, Male, Metabolome, Obesity, Morbid, Pericardium, Triglycerides, Ventricular Dysfunction, Left.
  • Gaborit, B, Jacquier, A, Kober, F, Abdesselam, I, Cuisset, T, Boullu-Ciocca, S, Emungania, O, Alessi, MC, Clement, K, Bernard, M & Dutour, A 2012, “Bariatric surgery induces an improvement of left ventricular function and differential effects on cardiac ectopic fat deposition”, Fundamental & Clinical Pharmacology, vol. 26, p. 3-4.

  • Gaborit, B, Jacquier, A, Kober, F, Abdesselam, I, Cuisset, T, Boullu-Ciocca, S, Emungania, O, Alessi, M-C, Clément, K, Bernard, M & Dutour, A 2012, “Effects of bariatric surgery on cardiac ectopic fat: lesser decrease in epicardial fat compared to visceral fat loss and no change in myocardial triglyceride content”, Journal of the American College of Cardiology, vol. 60, no. 15, p. 1381-1389.
    Résumé : OBJECTIVES: This study investigated the effect of bariatric surgery (BS)-induced weight loss on cardiac ectopic fat using 3T magnetic resonance imaging in morbid obesity. BACKGROUND: Heart disease is one of the leading causes of mortality and morbidity in obese patients. Deposition of cardiac ectopic fat has been related to increased heart risk. Whether sustained weight loss can modulate epicardial fat or myocardial fat is unknown. METHODS: Twenty-three morbidly obese patients underwent 1H-magnetic resonance spectroscopy to determine myocardial triglyceride content (MTGC), magnetic resonance imaging to assess epicardial fat volume (EFV), cardiac function, and computed tomography visceral abdominal fat (VAF) measurements at baseline and 6 months after BS. RESULTS: The BS reduced body mass index significantly, from 43.1±4.5 kg/m2 to 32.3±4.0 kg/m2, subcutaneous fat from 649±162 cm2 to 442±127 cm2, VAF from 190±83 cm2 to 107±44 cm2, and EFV from 137±37 ml to 98±25 ml (all p<0.0001). There was no significant change in MTGC: 1.03±0.2% versus 1.1±0.2% (p=0.85). A significant reduction in left ventricular mass (118±24 g vs. 101±18 g) and cardiac output (7.1±1.6 l/min vs. 5.4±1.0 l/min) was observed and was statistically associated with weight loss (p<0.05). The loss in EFV was limited (-27±11%) compared to VAF diminution (-40±19%). The EFV variation was not correlated with percentage of body mass index or VAF loss (p=0.007). The ratio of %EFV to %VAF loss decreased with sleep apnea syndrome (1.34±0.3 vs. 0.52±0.08, p<0.05). CONCLUSIONS: Six-month BS modulates differently cardiac ectopic fat deposition, with a significant decrease in epicardial fat and no change in myocardial fat. Epicardial fat volume loss was limited in patients with sleep apnea. (Impact of Bariatric Surgery on Epicardial Adipose Tissue and on Myocardial Function; NCT01284816).
    Mots-clés : Adult, Bariatric Surgery, Body Mass Index, crmbm, Female, Follow-Up Studies, Heart Diseases, Humans, Intra-Abdominal Fat, Lipid Metabolism, Magnetic Resonance Imaging, Cine, Magnetic Resonance Spectroscopy, Male, Myocardium, Obesity, Morbid, Pericardium, Retrospective Studies, Risk Factors, Tomography, X-Ray Computed, Triglycerides.
    Note Note
    <p>Gaborit, Benedicte<br />Jacquier, Alexis<br />Kober, Frank<br />Abdesselam, Ines<br />Cuisset, Thomas<br />Boullu-Ciocca, Sandrine<br />Emungania, Olivier<br />Alessi, Marie-Christine<br />Clement, Karine<br />Bernard, Monique<br />Dutour, Anne<br />Journal article<br />Journal of the American College of Cardiology<br />J Am Coll Cardiol. 2012 Oct 9;60(15):1381-1389. doi: 10.1016/j.jacc.2012.06.016. Epub 2012 Aug 29.</p>
    Note Note
    The following values have no corresponding Zotero field:<br/>Author Address: Department of Endocrinology, Metabolic Diseases and Nutrition, Centre Hospitalier Universitaire Nord, Marseille, France; Institut National de la Sante et de la Recherche Medicale, Unite Mixte de Recherche 1062 and Institut National de la Recherche Agronomique, Unite Mixte de Recherche 1260, Marseille, France; Centre de Resonance Magnetique Biologique et Medicale, Unite Mixte de Recherche Centre National de la Recherche Scientifique 6612, Marseille, France; Centre d'investigation Clinique, Hopital Nord, Marseille, France. Electronic address: benedicte.gaborit@ap-hm.fr.<br/>Label: A<br/>DOI: ACL<br/>C2 - Heart<br/>ET - 2012/09/04<br/>

  • Gaborit, B, Kober, F, Jacquier, A, Moro, PJ, Flavian, A, Quilici, J, Cuisset, T, Simeoni, U, Cozzone, P, Alessi, M-C, Clément, K, Bernard, M & Dutour, A 2012, “Epicardial fat volume is associated with coronary microvascular response in healthy subjects: a pilot study”, Obesity (Silver Spring, Md.), vol. 20, no. 6, p. 1200-1205.
    Résumé : Epicardial fat (EF) is an active ectopic fat depot, which has been associated with coronary atherosclerosis, and which could early influence endothelial function. We thus investigated the relationship between EF and endothelium-dependent vasoreactivity of the coronary microcirculation, in highly selected healthy volunteers. Myocardial blood flow (MBF) was determined by measuring coronary sinus flow with velocity-encoded cine magnetic resonance imaging (MRI) at 3T. We measured MBF at baseline and in response to sympathetic stimulation by cold pressor testing (CPT) in 30 healthy volunteers with normal left ventricular (LV) function (age 22 ± 4 years, BMI = 21.3 ± 2.8 kg/m(2)). EF volume was volumetrically assessed by manual delineation on short-axis views. CPT was applied by immersing one foot in ice water for 4 min. Mean EF volume was 56 ± 26 ml and mean LV mass 100 ± 28 g. CPT significantly increased heart rate (HR) by 32 ± 19%, systolic blood pressure by 14 ± 10%, and rate-pressure product by 45 ± 25%, P < 0.0001. The increase in HR, reflecting sympathetic stimulation, was not influenced by sex, age or EF volume. CPT induced a decrease in coronary vascular resistance (135 ± 72 vs. 100 ± 42 mm Hg.ml(-1).min.g, P = 0.0006), and a significant increase in MBF (0.81 ± 0.37 vs. 1.24 ± 0.56 ml.min(-1).g(-1), P < 0.0001). Interestingly, we found a significant negative correlation between EF volume and ΔMBF (r= - 0.40, P = 0.03), which remained significant after adjusting for ΔHR. ΔMBF was also associated with adiponectin (r = 0.41, P = 0.046), but not with waist circumference, BMI, C-reactive protein, lipid or glycemic parameters. In multivariate analysis, adiponectin and EF volume remained both independently associated with ΔMBF. A high EF amount is associated with a lower coronary microvascular response, suggesting that EF could early influence endothelial function.
    Mots-clés : Adolescent, Adult, Blood pressure, Cold Temperature, Coronary Artery Disease, Coronary Circulation, Coronary Vessels, crmbm, Endothelium, Vascular, Female, Humans, Male, Microcirculation, Pilot Projects, Reproducibility of Results, Ventricular Function, Left, Young Adult.

  • Peyrol, M, Sbragia, P, Orabona, M, Casalta, A-C, Laine, M, Decourt, A, Quatre, A, Jacquier, A, Siddo, ND & Paganelli, F 2012, “Ventricular allorhythmia during infarct-related ventricular tachycardia”, Journal of electrocardiology, vol. 45, no. 4, p. 394-397.
    Résumé : Ventricular allorhythmia is an electrocardiogram feature leading to a pattern of "regularly irregular" arrhythmia mainly reported during non-life-threatening organized atrial tachycardia. We report the infrequent case of a patient presenting with ventricular allorhythmia during infarct-related ventricular tachycardia. The potential mechanisms of this tachycardia are discussed.
    Mots-clés : Aged, Electrocardiography, Electrophysiologic Techniques, Cardiac, Humans, Male, Myocardial infarction, Tachycardia, Ventricular, Ventricular Function.

2011

Journal Article

  • Jacquier, A, Kober, F, Bun, S, Giorgi, R, Cozzone, PJ & Bernard, M 2011, “Quantification of myocardial blood flow and flow reserve in rats using arterial spin labeling MRI: comparison with a fluorescent microsphere technique”, NMR in biomedicine, vol. 24, no. 9, p. 1047-1053.
    Résumé : To quantify noninvasively myocardial blood flow (MBF) and MBF reserve in isoflurane-anesthetized rats using the Look-Locker flow-alternating inversion recovery gradient-echo arterial spin labeling technique (LLFAIRGE-ASL), and to compare the results with the fluorescent microsphere (FM) technique. Male Wistar rats (weight = 200-240 g, n = 21) were anesthetized with 2.0% isoflurane. Hemodynamic parameters were recorded. In seven rats, MBF was assessed on a Bruker Biospec 4.7T MR system using an ECG- and respiration-gated LLFAIRGE-ASL (pixel size = 234 × 468µm(2) , TE = 1.52ms) at rest and during adenosine infusion (140 µg/kg/min). A mixture of 200 000 FM was injected into a second group of rats at rest and during adenosine infusion (n = 7 each), under similar physiologic conditions. Hearts and skeletal muscle samples were processed for fluorescence spectroscopy. Two-tailed unpaired, paired Student's t-test and ANOVA were used to compare groups. MBF measured with LLFAIRGE-ASL was 5.2 ± 1.0 mL/g/min at rest and 13.3 ± 3.0 mL/g/min during adenosine infusion. Results obtained with fluorescent microspheres yielded 5.9 ± 2.3 mL/g/min (nonsignificant vs. LLFAIRGE-ASL, p = 0.9) at rest and 13.1 ± 2.1 mL/g/min (nonsignificant vs. LLFAIRGE-ASL, p = 0.4) during adenosine infusion. Myocardial blood flow reserve measured using LLFAIRGE-ASL and FM were not significantly different (2.5 ± 0.6 vs. 2.4 ± 0.9, respectively; p = 0.8). Hemodynamic parameters during the experiments were not different between the groups. The myocardial blood flow reserve determined under isoflurane anesthesia was 2.5 ± 0.6, which was not different from the value obtained with FM. LLFAIRGE-ASL provided MBF maps with high spatial resolution in rats under isoflurane anesthesia. LLFAIRGE-ASL is a noninvasive measure to assess myocardial blood flow reserve and provides an interesting tool for cardiovascular research.
    Mots-clés : Adenosine, Animals, Arteries, Coronary Circulation, crmbm, Fluorescence, Heart, Heart Ventricles, Hemodynamics, Magnetic Resonance Imaging, Magnetic Resonance Imaging, Cine, Male, Microspheres, Myocardium, Rats, Rats, Sprague-Dawley, Spin Labels, Ventricular Function.
    Note Note
    <p>Jacquier, Alexis<br/>Kober, Frank<br/>Bun, Soksithikun<br/>Giorgi, Roch<br/>Cozzone, Patrick J<br/>Bernard, Monique<br/>Research Support, Non-U.S. Gov't<br/>England<br/>NMR in biomedicine<br/>NMR Biomed. 2011 Nov;24(9):1047-53. doi: 10.1002/nbm.1645. Epub 2011 Jan 25.</p>
    Note Note
    The following values have no corresponding Zotero field:<br/>Author Address: Centre de Resonance Magnetique Biologique et Medicale (CRMBM), UMR 6612 CNRS/Universite de la Mediterranee, Faculte de Medecine, Marseille, France. alexis.jacquier@ap-hm.fr<br/>ET - 2011/01/26<br/>
    Note Note
    <p>Journal article <br/>NMR in biomedicine <br/>NMR Biomed. 2011 Jan 25. doi: 10.1002/nbm.1645.</p>
    Note Note
    <p>The following values have no corresponding Zotero field:<br />Author Address: Centre de Resonance Magnetique Biologique et Medicale (CRMBM), UMR 6612 CNRS/Universite de la Mediterranee, Faculte de Medecine, Marseille, France; Service de Radiologie Cardiovasculaire, Centre Hospitalo Universitaire la Timone, Marseille, France. alexis.jacquier@ap-hm.fr.<br />ET - 2011/01/26</p>

  • Jacquier, A, Prost, C, Amabile, N, Giorgi, R, Flavian, A, Gaubert, J-Y, Varoquaux, A, Paganelli, F, Bartoli, J-M & Moulin, G 2011, “Gadolinium chelate kinetics in cardiac MR imaging of myocarditis: comparison to acute myocardial infarction and impact on late gadolinium enhancement”, Investigative radiology, vol. 46, no. 11, p. 705-710.
    Résumé : OBJECTIVES: To compare the kinetics of gadolinium in myocarditis and myocardial infarction and to establish the best interval between contrast injection and late gadolinium-enhanced (LGE) image acquisition for the diagnosis of acute myocarditis. METHODS: Seventeen patients with acute myocarditis and 12 with acute myocardial infarction underwent Look-Locker sequences before and after administration of 0.2 mmol/kg gadolinium chelate for a period of 14 minutes. The apparent longitudinal relaxation rates (R'1) were calculated from left ventricular blood, enhanced and normal myocardium. LGE cardiac magnetic resonance images were acquired at 5, 10, and 15 minutes after contrast injection. The contrast between enhanced and normal myocardium (Contrastenhaced-normal) was measured, and the quality of the images was analyzed. RESULTS: A faster decline in the R'1 values measured in the areas of myocardial enhancement was recorded in myocarditis than that in myocardial infarction. In myocarditis, the Contrastenhaced-normal values decreased over time (from 60.7 ± 35.1 at 5 minutes vs. 42.1 ± 26.7 at 15 minutes; P = 0.001). However, in myocardial infarction, the Contrastenhaced-normal value remained stable in time (60.7 ± 22.9 at 5 minutes vs. 68.8 ± 16.6 at 15 minutes; P = ns). CONCLUSION: The gadolinium kinetics of acute myocarditis are different from those of acute myocardial infarction. In myocarditis, LGE images acquired 5 minutes after contrast injection provide higher Contrastenhaced-normal and better image quality compared with images taken at later points.
    Mots-clés : Acute Disease, Chi-Square Distribution, Contrast Media, Meglumine, Myocardial infarction, Myocarditis, Organometallic Compounds.

  • Jolibert, M, Vidal, V, Cohen, F, Bartoli, J-M, Moulin, G, Jacquier, A & Gaubert, J-Y 2011, “[Improvement of pulmonary angiography in the framework of a maintenance of certification]”, Journal de radiologie, vol. 92, no. 1, p. 20-24.
    Résumé : PURPOSE: This evaluation of clinical practices (pulmonary embolus) was performed to evaluate the quality of CT pulmonary angiograms for suspected acute pulmonary embolus. MATERIALS AND METHODS: Five validated criteria evaluating both the acquisition technique and the quality of image interpretation were selected: slice thickness, pulmonary arterial enhancement over 250 HU, caudocranial acquisition, visualization of fifth order pulmonary arterial branches, and right-left ventricular ratio in the presence of pulmonary embolus. Forty CT pulmonary angiograms were reviewed before and after implementation of a practice quality improvement program: modification of acquisition protocol, training of medical and paramedical staff, and implementation of a standardized radiology report. RESULTS: Thin collimation was already implemented. The implementation of two other technical parameters significantly improved the technical quality of the examinations. The detection of findings with adverse clinical outcome was also significantly improved. Only the accuracy of detection of embolus involving fifth order pulmonary arterial branches could not be improved, a criteria allowing formal exclusion of pulmonary embolus. CONCLUSION: This study resulted in an improvement in the quality of CT pulmonary angiograms and increased awareness of radiologists for the prognostic value of right ventricular dilatation. It has also underscored the need for quality control of a CT pulmonary angiogram prior to interpretation.
    Mots-clés : Angiography, Clinical Competence, Pulmonary Embolism, Tomography, X-Ray Computed.

  • Moro, P-J, Flavian, A, Jacquier, A, Kober, F, Quilici, J, Gaborit, B, Bonnet, J-L, Moulin, G, Cozzone, PJ & Bernard, M 2011, “Gender differences in response to cold pressor test assessed with velocity-encoded cardiovascular magnetic resonance of the coronary sinus”, Journal of cardiovascular magnetic resonance: official journal of the Society for Cardiovascular Magnetic Resonance, vol. 13, p. 54.
    Résumé : BACKGROUND: Gender-specific differences in cardiovascular risk are well known, and current evidence supports an existing role of endothelium in these differences. The purpose of this study was to assess non invasively coronary endothelial function in male and female young volunteers by myocardial blood flow (MBF) measurement using coronary sinus (CS) flow quantification by velocity encoded cine cardiovascular magnetic resonance (CMR) at rest and during cold pressor test (CPT). METHODS: Twenty-four healthy volunteers (12 men, 12 women) underwent CMR in a 3 Tesla MR imager. Coronary sinus flow was measured at rest and during CPT using non breath-hold velocity encoded phase contrast cine-CMR. Myocardial function and morphology were acquired using a cine steady-state free precession sequence. RESULTS: At baseline, mean MBF was 0.63 ± 0.23 mL·g⁻¹·min⁻¹ in men and 0.79 ± 0.21 mL·g⁻¹·min⁻¹ in women. During CPT, the rate pressure product in men significantly increased by 49 ± 36% (p < 0.0001) and in women by 52 ± 22% (p < 0.0001). MBF increased significantly in both men and women by 0.22 ± 0.19 mL·g⁻¹·min⁻¹ (p = 0.0022) and by 0.73 ± 0.43 mL·g⁻¹·min⁻¹ (p = 0.0001), respectively. The increase in MBF was significantly higher in women than in men (p = 0.0012). CONCLUSION: CMR coronary sinus flow quantification for measuring myocardial blood flow revealed a higher response of MBF to CPT in women than in men. This finding may reflect gender differences in endothelial-dependent vasodilatation in these young subjects. This non invasive rest/stress protocol may become helpful to study endothelial function in normal physiology and in physiopathology.
    Mots-clés : Adolescent, Adult, Blood Flow Velocity, Blood pressure, Cold Temperature, Coronary Circulation, Coronary Sinus, crmbm, Endothelium, Vascular, Female, France, Hand, Heart Rate, Humans, Immersion, Magnetic Resonance Imaging, Cine, Male, Myocardial Perfusion Imaging, Observer Variation, Predictive Value of Tests, Reproducibility of Results, Sex Factors, Ventricular Function, Left, Young Adult.

  • Viallon, M, Jacquier, A, Rotaru, C, Delattre, BMA, Mewton, N, Vincent, F & Croisille, P 2011, “Head-to-head comparison of eight late gadolinium-enhanced cardiac MR (LGE CMR) sequences at 1.5 tesla: from bench to bedside”, Journal of magnetic resonance imaging: JMRI, vol. 34, no. 6, p. 1374-1387.
    Résumé : PURPOSE: To compare-theoretically and experimentally-clinically available two-dimensional/three-dimensional (2D/3D), breathhold and non-breathhold, inversion-recovery (IR) gradient-echo (GRE) sequences used to differentiate between nonviable injured and normal myocardium with late gadolinium-enhanced techniques (IR-GRE2D sequence is used as a reference), and to evaluate their respective clinical benefit. MATERIALS AND METHODS: Six breathhold (2D-IR-GRE, 3D-IR-GRE, balanced steady-state free precession 2D-IR-bSSFP and 3D-IR-bSSFP, phase-sensitive 2D-PSIR-GRE, and 2D-PSIR-bSSFP) and two non-breathhold late gadolinium-enhanced techniques (single-shot 2D-ssbSSFP and 2D-PSIR-ssbSSFP) were consecutively performed in 32 coronary artery disease patients with chronic myocardial infarction. Qualitative assessment and manual planimetry were performed by two independent observers. Quantitative assessment was based on percentage signal intensity elevation between injured and normal myocardium and contrast-to-noise ratio. Theoretical simulations were compared with experimental measurements performed on phantoms with various concentrations of gadolinium. RESULTS: The 3D-IR-GRE image quality appeared better than the other 2D and 3D sequences, showing better delineation of complex nontransmural lesions, with significantly higher percentage signal intensity and contrast-to-noise ratio. PSIR techniques appeared more limited in differentiating sub-endocardial lesions and intracavity blood pool, but in all other cases were comparable to the other techniques. Single-shot PSIR-ssbSSFP appeared to be a valuable alternative technique when breathhold cannot be achieved. CONCLUSION: We recommend 3D-IR-GRE as the method of choice for late gadolinium-enhanced cardiac magnetic resonance imaging in clinical practice.
    Mots-clés : Gadolinium, Myocardial infarction, Myocardium, Observer Variation, Phantoms, Imaging.

  • Vidal, V, Jacquier, A, Giorgi, R, Pineau, S, Moulin, G, Petit, P, Girard, N, Bartoli, J-M & Gorincour, G 2011, “[Radiology as seen by medical students]”, Journal de radiologie, vol. 92, no. 5, p. 393-404.
    Résumé : PURPOSE: To determine the impact of exposing medical students to medical imaging during the first year of the second cycle of medical school (DCEM1) on their perception of this medical specialty and the acquisition of its basic concepts. MATERIALS AND METHODS: All students in the 2007-2008 graduation class entering into the first year of the second cycle of medical school were anonymously enrolled into this project that included pre-rotation and post-rotation questionnaires, theory classes followed by clinical rotations with clearly predetermined objectives. RESULTS: A total of 108 students were enrolled, with 70% being females. The parents of the students had a medical or paramedical profession in 46.3% of cases. Before the rotation, 61.6% of students perceived a difference between a hospital-based practice and private practice. Fifty-two percent of students had a clear idea of their professional future prior to the rotation. Five students (4.7%) believed prior to the rotation that it might have an impact on their professional future, versus 63% after the rotation (P<0.0001). The students whose parents work in the medical or paramedical field do not have a better defined idea of their professional future; on the other hand, they have more interest for radiology (73.6% with high or very high interest versus 52.8%, P=0.03). After the rotation, there was a significant increase in the number of students with high or very high interest for radiology (77.8% versus 66.7%, P=0.023). A student noted that he would redirect his career to radiology. There was also a significant increase in the number of students perceiving a difference between a hospital-based practice and private practice (82.2% versus 61.6%, P=0.003). With regards to radiology knowledge before and after the rotation, there was a significant increase of mean scores (P<0.001). Eighty-eight percent of students were satisfied or very satisfied with the radiology rotation. Overall, the students believe that 70% of the objectives were achieved. The only criticism from the students was that the clinical instructors were overworked. CONCLUSION: Early exposure of medical students to radiology increases their level of interest for the specialty and increases the perception of differences between a hospital-based practice and private practice. The overall knowledge of students about radiology was improved, but the workload of clinical instructors impaired the quality of the rotation.
    Mots-clés : Attitude, Education, Medical, Radiology, Students, Medical.

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