title: Diagnostic Accuracy of 3.0-T Magnetic Resonance T1 and T2 Mapping and T2-Weighted Dark-Blood Imaging for the Infarct-Related Coronary Artery in Non-ST-Segment Elevation Myocardial Infarction.
abstract: BACKGROUND
  Patients with recent non-ST-segment elevation myocardial infarction commonly have heterogeneous characteristics that may be challenging to assess clinically.
  
  
  RESULTS
  We prospectively studied the diagnostic accuracy of 2 novel (T1, T2 mapping) and 1 established (T2-weighted short tau inversion recovery [T2W-STIR]) magnetic resonance imaging methods for imaging the ischemic area at risk and myocardial salvage in 73 patients with non-ST-segment elevation myocardial infarction (mean age 57±10 years, 78% male) at 3.0-T magnetic resonance imaging within 6.5±3.5 days of invasive management. The infarct-related territory was identified independently using a combination of angiographic, ECG, and clinical findings. The presence and extent of infarction was assessed with late gadolinium enhancement imaging (gadobutrol, 0.1 mmol/kg). The extent of acutely injured myocardium was independently assessed with native T1, T2, and T2W-STIR methods. The mean infarct size was 5.9±8.0% of left ventricular mass. The infarct zone T1 and T2 times were 1323±68 and 57±5 ms, respectively. The diagnostic accuracies of T1 and T2 mapping for identification of the infarct-related artery were similar (P=0.125), and both were superior to T2W-STIR (P<0.001). The extent of myocardial injury (percentage of left ventricular volume) estimated with T1 (15.8±10.6%) and T2 maps (16.0±11.8%) was similar (P=0.838) and moderately well correlated (r=0.82,P<0.001). Mean extent of acute injury estimated with T2W-STIR (7.8±11.6%) was lower than that estimated with T1 (P<0.001) or T2 maps (P<0.001).
  
  
  CONCLUSIONS
  In patients with non-ST-segment elevation myocardial infarction, T1 and T2 magnetic resonance imaging mapping have higher diagnostic performance than T2W-STIR for identifying the infarct-related artery. Compared with conventional STIR, T1 and T2 maps have superior value to inform diagnosis and revascularization planning in non-ST-segment elevation myocardial infarction.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT02073422.
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom.|BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom.
authors.forename: Jamie
authors.initials: J
authors.lastname: Layland
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom.
authors.forename: Samuli
authors.initials: S
authors.lastname: Rauhalammi
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom.|BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom.
authors.forename: Matthew M Y
authors.initials: MM
authors.lastname: Lee
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom.|BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom.
authors.forename: Nadeem
authors.initials: N
authors.lastname: Ahmed
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom.
authors.forename: Jaclyn
authors.initials: J
authors.lastname: Carberry
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom.
authors.forename: Vannesa
authors.initials: V
authors.lastname: Teng Yue May
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom.
authors.forename: Stuart
authors.initials: S
authors.lastname: Watkins
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom.
authors.forename: Christie
authors.initials: C
authors.lastname: McComb
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom.|BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Mangion
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom.
authors.forename: John D
authors.initials: JD
authors.lastname: McClure
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom.|BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Carrick
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom.
authors.forename: Anna
authors.initials: A
authors.lastname: O'Donnell
authors.affiliation: Hairmyres Hospital, East Kilbride, United Kingdom.
authors.forename: Arvind
authors.initials: A
authors.lastname: Sood
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom.
authors.forename: Margaret
authors.initials: M
authors.lastname: McEntegart
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom.
authors.forename: Keith G
authors.initials: KG
authors.lastname: Oldroyd
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Radjenovic
authors.affiliation: West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom colin.berry@glasgow.ac.uk.|BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom.
authors.forename: Colin
authors.initials: C
authors.lastname: Berry
mesh_terms: D000368:Aged; D016477:Artifacts; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D000072658:Non-ST Elevated Myocardial Infarction / Q000000981:diagnostic imaging*; D009942:Organometallic Compounds / Q000008:administration & dosage; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol
keywords: acute coronary syndrome; area at risk; edema; mapping; noninvasive imaging; non–ST‐segment elevation acute coronary syndrome