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Delayed enhancement and T2-weighted cardiovascular magnetic resonance imaging differentiate acute from chronic myocardial infarction

Official URL:https://doi.org/10.1161/01.CIR.0000127428.10985.C6
PubMed:View item in PubMed
Creators Name:Abdel-Aty, H. and Zagrosek, A. and Schulz-Menger, J. and Taylor, A.J. and Messroghli, D. and Kumar, A. and Gross, M. and Dietz, R. and Friedrich, M.G.
Journal Title:Circulation
Journal Abbreviation:Circulation
Page Range:2411-2416
Date:25 May 2004
Keywords:Edema, Magnetic Resonance Imaging, Myocardial Infarction
Abstract:Background- Delayed enhancement (DE) cardiovascular magnetic resonance (CMR) detects acute and chronic myocardial infarction (MI) by visualizing contrast media accumulation in infarcted segments. T2-weighted CMR depicts infarct-related myocardial edema as a marker of acute but not chronic myocardial injury. We investigated the clinical utility of an approach combining both techniques to differentiate acute from chronic MI. Methods and Results- Seventy-three MI patients were studied in 2 groups. Group A consisted of 15 acute MI patients who were studied twice, on day 1 and 3 months after MI. In group B, 58 patients with acute or chronic MI underwent 1 CMR scan. T2-weighted and DE images of matched slices were acquired on a 1.5-T system. In group A, quantitative segmental and region of interest-based analyses were performed to observe signal changes between the acute and chronic phases. In group B, T2-weighted and DE images were examined visually by 2 blinded observers for the presence or absence of hyperintense areas in corresponding segments. For infarct localization, coronary angiography and/or ECG changes served as the reference standard. In group A, the contrast-to-noise ratio on T2-weighted images dropped in the infarcted segments from 2.7±1.1 on day 1 to 0.1±1.2 after 3 months (P<0.0001). There was no significant change in contrast-to-noise ratio in DE images (1.9±1.5 versus 1.3±1.0; P=NS). The qualitative assessment of T2-weighted and DE images in group B yielded a specificity of 96% to differentiate acute from chronic lesions. Conclusions- An imaging approach combining DE and T2-weighted CMR accurately differentiates acute from chronic MI.
Publisher:American Heart Association (U.S.A.)
Item Type:Article

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