Characterizing myocardial edema and hemorrhage using T2, T2*, and diastolic wall thickness post acute myocardial infarction
© Zia et al; licensee BioMed Central Ltd. 2010
Published: 21 January 2010
Our goal was to demonstrate myocardial edema using T2 spiral and diastolic wall thickness (DWT) and myocardial hemorrhage using T2* in patients post acute myocardial infarction (AMI) at 2 early time intervals.
Enhanced T2, often identified with area at risk (AAR), combined with consideration of T2* and DWT may facilitate interpretation of potentially complex patterns of myocardial damage and tissue response infarction zones.
Patients were enrolled post AMI (creatine kinase >500 IU/L) and underwent CMR on a GE Signa Excite, 1.5 T scanner with a 8-channel receive coil at 48 hours and 3 weeks post MI. T2 maps were computed from a previously validated cardiac-gated spiral imaging sequence with T2 preparations yielding TEs = 2.9, 24.3, 88.2, 184.2 ms to assess myocardial edema. The T2* sequence was a multiecho acquisition with 8 echoes (between 1.4 and 12.7 ms) acquired at TR = 14.6 ms. T2-weighted imaging using a breath-hold triple IR fast spin echo sequence and delayed hyperenhancement (DHE) were also performed.
Assessing the presence and evolution of edema and myocardial hemorrhage early post AMI demonstrates distinct patterns. If myocardial hemorrhage is present, then early scans are affected by the competing effects of T2*, counteracting an increased T2 signal. This may be important in accurately quantifying AAR and identifying those patients most likely to suffer deleterious left ventricular remodeling.
This article is published under license to BioMed Central Ltd.