title: Anatomical and functional evaluation of the myocardium in patients with acute coronary syndrome (NSTEMI) using MR imaging.
abstract: OBJECTIVE
  The aim of our study was to evaluate the role of magnetic resonance (MR) imaging in identifying the location and extent of acute ischaemic injury to predict reversibility and distinguish areas of acute from chronic ischaemia in patients with acute coronary syndrome non- ST-elevation myocardial infarction (NSTEMI).
  
  
  METHODS
  We evaluated 22 patients with NSTEMI acute coronary syndrome confirmed by coronary angiography (CA). We studied ventricular function indices and segmental changes in wall thickness and kinetics by cine-MR imaging sequences. Subsequently, we evaluated myocardial wall oedema with T2-weighted black-blood short-tau inversion recovery turbo spin echo (T2 BB-STIRTSE) sequences and identified areas of myocardial necrosis using T1-weighted turbo field-echo inversion recovery (T1 TFE-IR) sequences after contrast material administration.
  
  
  RESULTS
  The results obtained with the single sequences were as follows: T2 BB-STIR-TSE: 96.8% sensitivity, 100% specificity, 99.7% negative predictive value, 99.7% positive predictive value; T1 TFE-IR: 45.8% sensitivity, 96.9% specificity, 92.3% negative predictive value, 90.3% positive predictive value; systolic wall thickening: 87.5% sensitivity, 91.8% specificity, 98.7% negative predictive value, 50% positive predictive value, 91.4% accuracy.
  
  
  CONCLUSIONS
  Our study suggests that the sequences used for evaluating oedema and assessing viability allow for precise localisation and differentiation of areas of acute and chronic ischaemia by quantifying the possible mismatch between ischaemia and necrosis.
authors.affiliation: Terapia Radiante, Università degli studi di Roma "Tor Vergata" (PTV), Viale Oxford 81, 00133, Roma, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Romagnoli
authors.forename: M
authors.initials: M
authors.lastname: Sperandio
authors.forename: M
authors.initials: M
authors.lastname: Di Roma
authors.forename: S
authors.initials: S
authors.lastname: Giura
authors.forename: C
authors.initials: C
authors.lastname: Cicciò
authors.forename: F
authors.initials: F
authors.lastname: Della Gatta
authors.forename: G
authors.initials: G
authors.lastname: Simonetti
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications* / Q000000981:diagnostic imaging; D003287:Contrast Media; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000209:etiology; D009336:Necrosis; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA