- Poster presentation
- Open Access
SSFP cine images early post-gadolinium improve detection of myocardial oedema in acute myocardial infarction compared to T2-weighted dark blood turbo spin echo images
© Chan et al; licensee BioMed Central Ltd. 2012
- Published: 1 February 2012
- Myocardial Oedema
- Dark Blood
- SSFP Cine
- Normal Remote Myocardium
- Post Contrast Phase
We performed adenosine stress MRI in patients with a recent MI and assessed the utility of SSFP cine images early post-contrast to image myocardial oedema compared with standard T2-weighted sequences. Early post-contrast SSFP cine images were able to reliably demonstrate tissue oedema.
Demonstration of myocardial oedema following MI allows differentiation of acute and chronic MI, and assessment of the area at risk of infarction. T2-weighted dark blood TSE imaging for oedema is technically demanding and prone to artefacts.
Our protocol for patients with acute MI include standard oedema imaging sequences and more recently T2 prepared single shot SSFP sequences, followed by adenosine-stress perfusion imaging. The short axis SSFP cine stack is performed immediately after the perfusion study in an early post contrast phase (2-3 minutes). We observed that the cine stack in this protocol showed high signal in the infarct area correlating with the distribution of oedema on T2-weighted sequences. We hypothesized that SSFP-cine images early post contrast might be a more robust and time efficient alternative to T2-weighted imaging with TSE sequences.
We analysed thirteen patients who underwent CMR following an acute coronary syndrome. We only included patients showing tissue oedema on short axis T2 TSE dark blood sequences. These images were compared with the corresponding selected slices in post-stress short axis SSFP-cine images and where available T2-prepared single shot SSFP images. Image analysis was performed using dedicated software, CMR42 (Circle CVI, Calgary, Canada). Left ventricular endo and epicardial contours were drawn manually on selected short axis slices. Myocardial oedema was calculated as >2SD from normal remote myocardium for each slice in both T2 TSE dark blood sequences and post-stress short axis SSFP-cine images.
Results of T2-weighted dark blood TSE and Post-stress perfusion cine SSFP imaging
T2-weighted dark blood TSE
Post-stress perfusion cine SSFP
Oedema volume (ml)
21.7 ± 9.1
31.7 ± 15.4
Oedema mass (g)
22.8 ± 9.5
33.2 ± 16.2
Relative percentage of oedema volume/Myocardial mass (%)
26.1 ± 6.3
38.0 ± 9.4
Oedema ratio relative to skeletal muscle
Median : 1.6 Range: 1.1 -3.3
SSFP-cine images early post-contrast are capable of detecting myocardial oedema. The extent and volume of oedema correlates well with that demonstrated on T2-prepared single shot SSFP sequences but is overestimated compared with standard T2 TSE sequences. SSFP-cine images early post-contrast may be a robust and time efficient way to image myocardial oedema and warrants further investigation in a prospective study.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.