- Poster presentation
- Open Access
Differentiation of acute and chronic myocardial infarction using T2-weighted imaging, late enhancement and T1 and T2 mapping - a pilot study at 3T
© Knobelsdorff et al.; licensee BioMed Central Ltd. 2014
- Published: 16 January 2014
- Steady State Free Precession
- Late Enhancement
- Diagnostic Image Quality
- Myocardial Lesion
- Chronic Myocardial Infarction
Qualitative assessment of myocardial T2-weighted and late enhancement (LGE) images has been demonstrated to differentiate acute from chronic myocardial infarction (AMI, CMI). Parametric mapping could help to overcome challenges in image quality and could contribute to making contrast media application obsolete. The aim of this pilot study was to analyze, whether T2- and T1-maps are useful to discriminate AMI from CMI.
Eight male patients with acute ST-elevation myocardial infarction underwent CMR at 3T during acute presentation and after >3 months latency. Five independent experienced readers, blinded to the patients' clinical state, qualitatively assessed the presence (yes/no) of an infarct-like myocardial lesion in three short axes acquired with several techniques: i) T2-weighted STIR (short-TI triple-inversion recovery prepared fast spin echo), ii) T2-map based on 3 single-shot SSFP (steady state free precession) images with different T2-preparation times, iii) native T1-map based on modified Look-Locker inversion recovery using 11 single-shot SSFP images, iv) T1-map 10 minutes after 0.2 mmol/kg body weight gadobutrol, and v) PSIR (phase sensitive inversion recovery) LGE. The results of all readers were pooled and the sensitivity to determine AMI and CMI was calculated.
Frequency of an infarct-like lesion in AMI and CMI detected by various CMR techniques
STIR T2 weighted
T1 Map native
T1 Map post
STIR + PSIR LGE
T2 Map + T1 Map native
T2 Map + T1 Map post-contrast
T2 Map + T1 native + T1 post-contrast
Post-contrast T1-maps and LGE agree closely in the detection of infarct-like lesions. STIR with diagnostic image quality is superior to detect AMI compared to T2-mapping, whereas native T1-mapping detects AMI with similar sensitivity as STIR, but with poor specificity. In summary, qualitative assessment of T1- and T2-maps performs not superiorly in the differentiation of AMI and CMI compared to STIR and LGE. Further studies are needed that analyze whether quantitative T1- and T2-relaxation times are helpful.
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