- Oral presentation
- Open Access
Balanced steady-state free precession cardiovascular magnetic resonance imaging of edema in reperfused acute myocardial infarcts - a translational study in animals and men
© Kumar et al; licensee BioMed Central Ltd. 2010
- Published: 21 January 2010
- Cardiovascular Magnetic Resonance
- Late Enhancement
- Cardiovascular Magnetic Resonance Imaging
- Remote Myocardium
- Left Circumflex Coronary Artery
Edema imaging is usually performed using T2-weighted STIR imaging. We hypothesized that balanced steady-state-free-precession (b-SSFP) sequences also have sensitivity to detect edema in acute reperfused ST-elevation myocardial infarction (STEMI).
The study was conducted in mini-pigs and patients with acute reperfused STEMI. In the mini-pigs, myocardial infarction was created by angiographically guided balloon occlusion of the proximal left circumflex coronary artery for ninety minutes. The animals were imaged on day 2 or 3 after experimental ischemia/reperfusion.
For the clinical arm, patients from the coronary care unit were included within four days after successful percutaneous coronary intervention for STEMI.
All CMR images were obtained on a 1.5 T clinical system (Siemens, Germany), using the following sequences in a short axis orientation (slice thickness 10 mm, 0 gap): conventional cine SSFP, T2-STIR (patients only), late enhancement (10 min after injection of 0.2 mmol/kg Gd-DTPA), applying typical sequence parameters. Semi-quantitative threshold-based image analysis of late enhancement images (LE) identified the infarct region and infarct area was calculated. In the infarction zone and remote myocardium, on corresponding T2-STIR and SSFP images, signal and contrast, as well as the area of edema were measured and compared using paired t-tests, correlation statistics.
In 13 pigs, the area of high SSFP signal and the area of LE correlated with R = 0.83. Signal intensity in the infarction zone on SSFP was higher than in the remote zone (203.5 ± 28.7 (edema) vs. 148 +/- 19.8 (remote), p < 0.001), with a contrast-to-noise ratio of 37 ± 13.
Myocardial Edema in both, experimental and clinical STEMI, can be detected using SSFP imaging with contrast similar to T2-STIR.
This article is published under license to BioMed Central Ltd.