T2-prepared SSFP improves diagnostic confidence in edema imaging in acute myocardial infarction compared to turbo spin echo.
T2-weighted MRI of edema in acute myocardial infarction (MI) provides a means of differentiating acute and chronic MI, and assessing the area at risk of infarction. Conventional T2-weighted imaging of edema uses a turbo spin-echo (TSE) readout with dark-blood preparation. Clinical applications of dark-blood TSE methods can be limited by artifacts such as posterior wall signal loss due to through-plane motion, and bright subendocardial artifacts due to stagnant blood. Single-shot imaging with a T2-prepared SSFP readout provides an alternative to dark-blood TSE and may be conducted during free breathing. We hypothesized that T2-prepared SSFP would be a more reliable method than dark-blood TSE for imaging of edema in patients with MI. In patients with MI (22 acute and nine chronic MI cases), T2-weighted imaging with both methods was performed prior to contrast administration and delayed-enhancement imaging. The T2-weighted images using TSE were nondiagnostic in three of 31 cases, while six additional cases rated as being of diagnostic quality yielded incorrect diagnoses. In all 31 cases the T2-prepared SSFP images were rated as diagnostic quality, correctly differentiated acute or chronic MI, and correctly determined the coronary territory. Free-breathing T2 prepared SSFP provides T2-weighted images of acute MI with fewer artifacts and better diagnostic accuracy than conventional dark-blood TSE.
Kellman
Peter
P
Laboratory of Cardiac Energetics, National Heart, Lung and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892-1061, USA. kellman@nih.gov
Aletras
Anthony H
AH
Mancini
Christine
C
McVeigh
Elliot R
ER
Arai
Andrew E
AE
D000208:Acute Disease; D016477:Artifacts; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004487:Edema / Q000175:diagnosis*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009203:Myocardial Infarction / Q000175:diagnosis*