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- Open Access
Quantitative assessment of myocardial edema using a breath-hold T2 mapping pulse sequence
© Shah et al; licensee BioMed Central Ltd. 2010
Published: 21 January 2010
An inflammatory response to various diseases, including acute myocardial ischemia, cardiac transplantation rejection and acute myocarditis, results in water accumulation in the myocardium. Excess water accumulation results in myocardial edema, which can lead to various conditions including myocardial stiffness, diastolic dysfunction, and tissue swelling . Conventional T2-weighted (T2w) MRI can be used to qualitatively detect myocardial edema, but often yield non-uniform signal due to surface coil effects . We propose to quantitatively detect myocardial edema using a breath-hold T2 mapping pulse sequence based on multi-echo, spin-echo (ME-SE) imaging .
To quantitatively assess myocardial edema using a breath-hold, ME-SE T2 mapping pulse sequence in patients with clinical evidence of cardiac disease.
Clinical history, T2 measurement, and diagnosis of myocardial edema
Patient age (years)
Diagnosis of myocardial edema (T2w/T2)
acute coronary syndrome
chronic coronary artery disease
mildly elevated troponin with normal coronary arteries
Conventional T2w images were qualitatively evaluated by a cardiologist for presence of myocardial edema. For the ME-SE data, myocardial contours were segmented manually using short-axis planes, and the corresponding pixel-by-pixel T2 maps were calculated by non-linear least square fitting of the mono-exponential relaxation curve. T2 values were averaged over the entire myocardium. The clinical reading and T2 data analysis were performed independently.
For the ME-SE data, an upper limit cutoff T2 value of 62.9 ms (5 standard deviations above the mean) was chosen based on prior ME-SE data obtained from a control group . The accuracy of quantitative detection of myocardial edema was correlated with qualitative evaluation.
This study demonstrates the feasibility of quantitatively detecting myocardial edema using a breath-hold ME-SE T2 mapping pulse sequence. Clinical evaluation for myocardial edema is challenging with conventional T2w imaging due to surface coil effects and lack of a normal myocardium reference signal. Future directions for this research include correlating increased T2 values with specific cardiac conditions and evaluating the clinical utility of this quantitative technique for assessment of myocardial edema.
Grant sponsor: AHA0790141N, AHA 0630041N, NIG R01-DK069373, NIG R01-EB000447-07A1, NIH R01-HL083309, DD CSDA 2006066.
This article is published under license to BioMed Central Ltd.