title: A new approach towards improved visualization of myocardial edema using T2-weighted imaging: a cardiovascular magnetic resonance (CMR) study.
abstract: OBJECTIVE
  To compare T2-weighted cardiovascular magnetic resonance (CMR) imaging with AASPIR (asymmetric adiabatic spectral inversion recovery) and STIR (short T1 inversion recovery) for myocardial signal intensity, image quality, and fat suppression.
  
  
  METHODS
  Forty consecutive patients (47 ± 16 years old) referred by cardiologists for CMR-based myocardial tissue characterization were scanned with both STIR and AASPIR T2-weighted imaging approaches. Signal intensity of left ventricular myocardium was normalized to a region of interest generating a signal-to-noise ratio (SNR). In six patients with regional edema on STIR the contrast-to-noise ratio (CNR) was assessed. Two independent observers used a scoring system to evaluate image quality and artifact suppression. Six healthy volunteers (three males, 32 ± 7 years) were recruited to compare fat suppression between AASPIR and STIR.
  
  
  RESULTS
  SNR of AASPIR was greater than STIR for basal (128 ± 44 vs. 83 ± 40, P < 0.001), mid- (144 ± 65 vs. 96 ± 39, P < 0.01), and apical (145 ± 59 vs. 105 ± 35, P < 0.05) myocardium. Improved image quality and greater suppression of artifacts was demonstrated with AASPIR. In patients with regional edema, CNR increased by 49% with AASPIR, while SNR of pericardial fat did not differ (44 ± 39 vs. 33 ± 30, P > 0.05).
  
  
  CONCLUSIONS
  Our findings support the implementation of an AASPIR-based approach for T2-weighted imaging due to improved pericardial fat suppression, image quality, and artifact suppression with greater CNR and SNR.
authors.affiliation: Stephenson CMR Centre at the Libin Cardiovascular Institute, University of Calgary, Department of Cardiac Sciences, Foothills Hospital, Calgary, Alberta, Canada.
authors.forename: Myra S
authors.initials: MS
authors.lastname: Cocker
authors.forename: Steven M
authors.initials: SM
authors.lastname: Shea
authors.forename: Oliver
authors.initials: O
authors.lastname: Strohm
authors.forename: Jordin
authors.initials: J
authors.lastname: Green
authors.forename: Hassan
authors.initials: H
authors.lastname: Abdel-Aty
authors.forename: Matthias G
authors.initials: MG
authors.lastname: Friedrich
mesh_terms: D000273:Adipose Tissue / Q000473:pathology; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003952:Diagnostic Imaging / Q000379:methods; D004487:Edema / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D009206:Myocardium / Q000473:pathology*; D010496:Pericardium / Q000473:pathology*