[Comparison of an edema-sensitive HASTE-TIRM sequence with delayed contrast enhancement in acute myocardial infarcts].
OBJECTIVE
Comparison between a fluid-sensitive (HASTE-TIRM)-sequence and delayed contrast-enhancement in patients with acute myocardial infarct (AMI) in MRI.


METHODS
32 patients with AMI were imaged 7 +/- 4 days after the time of infarction with a 1.5 T unit using a T2 HASTE-TIRM and a contrast-enhanced (CE) T1 turbo FLASH sequence. A threshold method (>2 SD in comparison with normal myocardium) was used to quantify the hyperintense zones in both sequences. The transmurality of the hyperintense regions was measured on a segmental basis.


RESULTS
The hyperintense areas were larger on the HASTE-TIRM sequence with 29.6 +/- 13.2 % of the left ventricular (LV) area as compared to the CE-MRI with 19.2 +/- 10 % of the LV area (p < 0.0001). The measured transmurality was higher with the HASTE-TIRM sequence than with the CE-MRI (p < 0.0001). While the correlation between CE-MRI and peak creatine kinase (CK max) was good (r = 0.59, p < 0.001), no correlation was found between the HASTE-TIRM sequence and CK max (r = 0.29, p = ns).


CONCLUSIONS
The peri-infarct edema can be depicted with a HASTE-TIRM sequence in addition to the non-viable infarct zone. The HASTE-TIRM sequence shows a higher transmurality of the hyperintense regions than the CE-MRI. The additional area depicted by the HASTE-TIRM sequence could represent functionally impaired but viable myocardium).
Stork
A
A
Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Eppendorff, Hamburg. astork@uke.uni-hamburg.de
Lund
G K
GK
Bansmann
M
M
Kemper
J
J
Weiss
F
F
Steiner
P
P
Meinertz
T
T
Adam
G
G
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003287:Contrast Media; D003402:Creatine Kinase / Q000097:blood; D004487:Edema / Q000175:diagnosis* / Q000628:therapy; D004562:Electrocardiography; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy; D015428:Myocardial Reperfusion Injury / Q000175:diagnosis; D009206:Myocardium / Q000473:pathology; D010490:Pericardial Effusion / Q000175:diagnosis* / Q000628:therapy; D010496:Pericardium / Q000473:pathology; D012680:Sensitivity and Specificity
D003287:Contrast Media; D003402:Creatine Kinase; D019786:Gadolinium DTPA