title: Determining microvascular obstruction and infarct size with steady-state free precession imaging cardiac MRI.
abstract: OBJECTIVE
  In cardiac MRI (cMRI) injection of contrast medium may be performed prior to the acquisition of cine steady-state free precession (SSFP) imaging to speed up the protocol and avoid delay before late Gadolinium enhancement (LGE) imaging. Aim of this study was to evaluate whether a condensed clinical protocol with contrast cine SSFP imaging is able to detect early microvascular obstruction (MO) and determine the infarct size compared to the findings of LGE inversion recovery sequences.
  
  
  METHODS
  The study complies with the Declaration of Helsinki and was performed following approval by the ethic committee of the University of Erlangen-Nuremberg. Written informed consent was obtained from every patient. 68 consecutive patients (14 females/54 males) with acute ST-elevation myocardial infarction (STEMI) treated by percutaneous coronary revascularization were included in this study. CMRI was performed 6.6±2 days after symptom onset and MO and infarct size in early contrast SSFP cine imaging were compared to LGE imaging.
  
  
  RESULTS
  MO was detected in 47/68 (69%) patients on cine SSFP and in 41/68 (60%) patients on LGE imaging. In 6 patients MO was found on cine SSFP imaging but was not detectable on LGE imaging. Infarct size on cine SSFP showed a strong agreement to LGE imaging (intraclass correlation coefficient [ICC] of 0.96 for enddiastolic, p<0.001 and 0.96 for endsystolic, p<0.001 respectively). Significant interobserver agreement was found measuring enddiastolic and endsystolic infarct size on cine SSFP imaging (p<0.01).
  
  
  CONCLUSIONS
  In patients after STEMI infarct size and presence of MO can be detected with contrast cine SSFP imaging. This could be an option in patients who are limited in their ability to comply with the demands of a cMRI protocol.
authors: Radiological Institute, Friedrich-Alexander-University-Erlangen-Nuremberg, Erlangen, Germany.
authors: Wolfgang
authors: W
authors: Wuest
authors: Radiological Institute, Friedrich-Alexander-University-Erlangen-Nuremberg, Erlangen, Germany.
authors: Michael
authors: M
authors: Lell
authors: Radiological Institute, Friedrich-Alexander-University-Erlangen-Nuremberg, Erlangen, Germany.
authors: Matthias
authors: M
authors: May
authors: Radiological Institute, Friedrich-Alexander-University-Erlangen-Nuremberg, Erlangen, Germany.
authors: Michael
authors: M
authors: Scharf
authors: Department of Internal Medicine II, Division of Cardiology, Friedrich-Alexander-University-Erlangen-Nuremberg, Erlangen, Germany.
authors: Christian
authors: C
authors: Schlundt
authors: Department of Internal Medicine II, Division of Cardiology, Friedrich-Alexander-University-Erlangen-Nuremberg, Erlangen, Germany.
authors: Stephan
authors: S
authors: Achenbach
authors: Radiological Institute, Friedrich-Alexander-University-Erlangen-Nuremberg, Erlangen, Germany.
authors: Michael
authors: M
authors: Uder
authors: Radiological Institute, Friedrich-Alexander-University-Erlangen-Nuremberg, Erlangen, Germany.
authors: Axel
authors: A
authors: Schmid
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D009206:Myocardium / Q000473:pathology*
chemical_list: D005682:Gadolinium