- Oral presentation
- Open Access
A simple visual algorithm incorporating the components of a routine CMR study improves the determination of infarct age compared with T2-CMR alone
© Smulders et al; licensee BioMed Central Ltd. 2013
- Published: 30 January 2013
- Individual Component
- Infarct Size
- Clinical Information
- Diagnostic Performance
- Additional Benefit
T2-weighted CMR is sensitive but perhaps not specific for detecting acute MI, because T2-hyperintensity can persist for months . Cine and delayed-enhancement (DE)-CMR may help in determining infarct age, since increased end-diastolic-wall-thickness (EDWT) and microvascular obstruction (MO) are frequently found in <1-month-old (acute) MI but not in 1-6-months-old (intermediate-aged) MI . Given that EDWT and MO potentially resolve before T2-hyperintensity, we hypothesized that a simple, visual algorithm incorporating these components with T2-CMR could improve the determination of infarct age.
221 CMR studies were performed at various time points post-MI in 117 STEMI patients enrolled prospectively and consecutively at two centers. True MI age was known given the STEMI date. Images were scored blinded to identity and clinical information. Pre-specified markers of acute MI were: hyperintensity on T2-CMR, MO on DE-CMR, and increased-EDWT (>150% of remote) on cine-CMR. Our algorithm incorporating multiple CMR components was based on: 1) EDWT and MO resolve before T2-hyperintensity, 2) since T2-hyperintensity eventually disappears, T2-size becomes smaller than infarct size over time.
Diagnostic performance of CMR for discriminating acute (<1-month-old) MI
Individual CMR components
T2 hyperintensity or (MO-or-iEDWT)
T2 hyperintensity and (MO-or-iEDWT)
A novel algorithm incorporating components of a routine CMR scan improves the determination of infarct age compared with T2-CMR alone. Certain CMR findings may be specific for intermediate-aged MI.
- JCMR. 2011, 13 (suppl 1): O68-Google Scholar
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