Detection of papillary muscle infarction by late gadolinium enhancement: incremental value of short-inversion time vs. standard imaging.
OBJECTIVE
Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging can detect myocardial scar in patients with myocardial infarction. The detection of papillary muscle infarction (PMI) may be difficult due to the bright blood signal. The aim of our study was to evaluate the incremental value of LGE CMR imaging using an inversion recovery (IR)-GRE with a short-inversion time (TI) over standard LGE imaging in identifying PMI.


RESULTS
Fifty-six patients with myocardial infarction were studied using a standard IR-GRE LGE sequence with an adjusted TI to null the signal intensity of normal myocardium and with a 3D IR-GRE with a short TI (<180 ms). Signal-to-noise and contrast-to-noise ratios (CNR) and the frequency of PMI were determined. Image quality and infarction sharpness were evaluated. The short-TI LGE sequence detected a higher number of PMI compared with standard LGE sequence (19/54 vs. 15/54) with an increased sharpness of PMI (84.2 vs. 53.3%). The CNR was higher between infarcted myocardium and blood (77.9 ± 60 vs. 19.3 ± 16, P < 0.001) and between PMI and blood (69.4 ± 51 vs. 39.4 ± 26, respectively, P = 0.0157).


CONCLUSIONS
Our data indicate that in patients with myocardial infarction, LGE CMR imaging using a short TI may be more sensitive than standard LGE imaging for the detection of PMI.
Division of Cardiology, Department of Heart and Lung, University Hospital of Parma, Via A. Gramsci 14, 43100, Parma, Italy. aldrovandiac@yahoo.it
Annachiara
A
Aldrovandi
Stijn P J
SP
De Ridder
Oliver
O
Strohm
Myra
M
Cocker
Rosa
R
Sandonato
Matthias G
MG
Friedrich
D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013997:Time Factors
D019786:Gadolinium DTPA