Visual detection and characterization of chronic myocardial infarctions in patients using native T1 maps at 3T
KeywordsCardiovascular Magnetic Resonance Late Gadolinium Enhancement Visual Detection Late Gadolinium Enhancement Image Remote Myocardium
Late Gadolinium Enhancement (LGE) Cardiovascular Magnetic Resonance (CMR) is routinely used for characterizing chronic myocardial infarctions (cMIs), but it is contraindicated in patients with end-stage chronic kidney disease. We investigated whether native T1 mapping at 3T can be used to detect and characterize cMIs in patients with prior STEMI and NSTEMI.
Breath-held 2D native T1 maps (8 TIs with 2 Look-Locker cycles of 3+5 images; minimum TI = 120ms; TI increment = 80 ms; flip angle = 35°; bandwidth = 1085 Hz/pixel; voxel size = 1.5x1.5x8mm3) and LGE images (IR-prepared FLASH; optimal TI to null remote myocardium; TR/TE = 6.54/3.27ms; flip angle = 20°; bandwidth = 460 Hz/pixel; voxel size = 1.2x1.2x8mm3) were acquired in patients with prior STEMI (n=15) and NSTEMI (n=17) at 3T at a median of 13.6 years after acute MI. cMI location, size and transmurality were determined using Mean+5SD criterion relative to remote myocardium. Visual detection of cMI territories on LGE images and T1 maps were assessed by two independent reviewers.
Native T1 maps can reliably detect and characterize cMIs in STEMI and NSTEMI patients when the location of remote myocardium is known. Further increase in image contrast may be necessary to improve visual detection sensitivity of chronic MI territories to the levels observed with LGE.
National Heart, Lung, and Blood Institute (RO1 HL091989) and American Heart Association Pre-Doctoral Fellowship (13PRE17210049).
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