Skip to main content

Detailing the role of parametric T1- and T2-mapping for differentiation of acute and chronic myocardial infarction

Background

T1- and T2-mapping in myocardial infarction may be helpful to discriminate acute from chronic stages (AMI, CMI). This study examines the role of T1- and T2-mapping versus today's T1- and T2-weighted imaging standard along with interpretation modes for discrimination of AMI from CMI.

Methods

Eight male patients with acute ST-elevation myocardial infarction underwent CMR at 3T (Siemens Verio) acutely and after >3 months. Imaging techniques included: T2-weighted imaging, late enhancement (LGE) as well as T2-mapping (3 single-shot SSFP-images), native T1-mapping (MOLLI, 11 single-shot SSFP-images), and T1-mapping 10min after 0.2mmol gadobutrol using non-product sequences. Image analysis included: 1) Visual assessment: Five independent readers assessed the presence (yes/no) of an infarct-like myocardial lesion. 2) Quantitative assessment per segment: Myocardial T2- and T1-relaxation times were determined for every segment and correlated to LGE. 3) Quantitative assessment per pixel: Based on reference T2- and T1- relaxation times, abnormal pixels were identified and correlated to LGE.

Results

1) T2-weighted images showed an infarct-like lesion in 82.9% of AMI and 27.8% of CMI, LGE in 95.0% / 100%, T2-map in 69.2% / 35.0%, native T1-map in 86.8% / 57.5%, and post-contrast T1-map in 95.0% / 91.9%. 2) The pattern of segmental abnormalities of T2- and T1-relaxation times in infarcted segments compared to remote myocardium was not consistent for a confident diagnosis of AMI and CMI. 3) Pixelwise threshold-based analysis of T2- and T1-maps exposed infarcted regions in the myocardium in AMI and CMI. The presence of T2-abnormalities in the chronic state and the classification of remote pixels as abnormal limited its diagnostic value. The figure shows the various images and maps as well as segmental relaxation times of one representative patient.

figure1

Figure 1

Conclusions

Referring to the studied mapping sequences, pixelwise analysis of T2- and T1-maps based on predefined thresholds that separate normal from abnormal was the most promising approach to read maps, whereas visual assessment and segmental analysis of T2- and T1-maps were less favorable. The discrimination of AMI and CMI is not facilitated using the tested T2- and T1-maps.

Funding

This project was supported by the Else Kröner-Fresenius Stiftung (Bad Homburg, Germany) (2010_A70).

Author information

Affiliations

Authors

Corresponding author

Correspondence to Florian von Knobelsdorff-Brenkenhoff.

Rights and permissions

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/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

von Knobelsdorff-Brenkenhoff, F., Prothmann, M., Dieringer, M.A. et al. Detailing the role of parametric T1- and T2-mapping for differentiation of acute and chronic myocardial infarction. J Cardiovasc Magn Reson 17, P9 (2015). https://doi.org/10.1186/1532-429X-17-S1-P9

Download citation

Keywords

  • Myocardial Infarction
  • Visual Assessment
  • Infarcted Region
  • Late Enhancement
  • Remote Myocardium