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Volume 18 Supplement 1

19th Annual SCMR Scientific Sessions

  • Poster presentation
  • Open Access

Reproducibility of native and contrast-enhanced CMR techniques to measure lesion size following acute myocardial infarction

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Journal of Cardiovascular Magnetic Resonance201618 (Suppl 1) :P92

  • Published:


  • Acute Myocardial Infarction
  • Acute Myocardial Infarction
  • Late Gadolinium Enhancement
  • Lesion Size
  • Native Imaging


The purpose of this study was to analyze the reproducibility of native and contrast-enhanced CMR techniques to measure lesion size after acute myocardial infarction (AMI) using native T1/T2 mapping, T2-weighted (T2w) imaging, contrast-enhanced late gadolinium enhancement (LGE), post-contrast T1 mapping and extracellular volume (ECV) quantification.


Lesion size was independently quantified by 2 experienced observers in total of 120 consecutive CMRs obtained in 30 patients within the first 6 months after AMI using native and contrast-enhanced sequences. Lesion sizes were quantified using a threshold method (cutoff >2SD of remote normal myocardium) on basal, midventricular and apical short-axis left ventricular slices. Lesion size is given as the mean of both observers. Bland-Altman analysis was performed to determine the agreement between the two observers. Non-parametric Levene's test was used to compare the variances of the relative differences. Statistical analysis was performed using GraphPad Prism 6.


The relative median difference of the native CMR techniques were -1.95% (-12.7% and 9.8%) for T2w, -5.3% (-19.6% and 14.8%) for native T1 and -4.0% (-23.9% and 9.9%) for native T2 (Fig. 1). Results for contrast-enhanced CMR imaging were: 2.9% (-4.5% and 10.5%) for LGE, 7.5% (-2.4% and 21.5%) for post-contrast T1 and -2.9% (-11.4% and 9%) for ECV measurement. Bland Altman analysis revealed a better agreement for all post-contrast sequences indicted by lower limits of agreement compared to native sequences (Figure 1). The increased variability of native imaging was caused by higher interobserver differences in small lesions with sizes between 0-15 %LV compared to lager lesions >15 %LV. This bias was not observed for post-contrast imaging.
Figure 1
Figure 1

The Bland-Altman graphs show the relative differences and limits of agreement for measurement of lesion size using the indicated sequences.


In general, there was a good agreement between the two observers to measure lesion size after AMI, but all post-contrast sequences had a better agreement compared to the native sequences. The low agreement of native imaging was mainly caused by higher interobserver differences in small lesions with lesion sizes between 0-15 %LV compared to lager lesions >15 %LV.

Authors’ Affiliations

Diagnostic and Interventional Radiology, University Hospital Eppendorf, Hamburg, Germany
General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Institute of Applied Sciences, Wedel, Germany
Phillips Research Laboratory, Hamburg, Germany


© Tahir et al. 2016

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 (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.