Cardiovascular magnetic resonance by non contrast T1-mapping allows assessment of severity of injury in acute myocardial infarction

Journal of Cardiovascular Magnetic Resonance

Research

Adrian P Banning¹  Florim Cuculi¹  Rajesh K Kharbanda¹  Robin P Choudhury²  Stefan Neubauer³  Jane M Francis³  Erica Dall'Armellina³  Vanessa M Ferreira³  Theodoros D Karamitsos³  Stefan K Piechnik³  Matthew D Robson³  Quang Le Si⁴ 

[1] Department of Cardiology, John Radcliffe Hospital, OX3 9DU, Oxford, UK;Department of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, OX3 9DU, Oxford, UK;Oxford Centre for Clinical Magnetic Resonance Research, Department of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, OX3 9DU, Oxford, UK;The Wellcome Trust Centre for Human Genetics, Roosevelt Drive, OX3 7BN, Oxford, UK;

关键词: Cardiovascular Magnetic Resonance;    Late Gadolinium Enhancement;    Microvascular Obstruction;    Late Gadolinium Enhancement Imaging;    Remote Myocardium;   

DOI  :  10.1186/1532-429X-14-15

 received in 2011-11-10, accepted in 2012-02-06,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundCurrent cardiovascular magnetic resonance (CMR) methods, such as late gadolinium enhancement (LGE) and oedema imaging (T2W) used to depict myocardial ischemia, have limitations. Novel quantitative T1-mapping techniques have the potential to further characterize the components of ischemic injury. In patients with myocardial infarction (MI) we sought to investigate whether state-of the art pre-contrast T1-mapping (1) detects acute myocardial injury, (2) allows for quantification of the severity of damage when compared to standard techniques such as LGE and T2W, and (3) has the ability to predict long term functional recovery.Methods3T CMR including T2W, T1-mapping and LGE was performed in 41 patients [of these, 78% were ST elevation MI (STEMI)] with acute MI at 12-48 hour after chest pain onset and at 6 months (6M). Patients with STEMI underwent primary PCI prior to CMR. Assessment of acute regional wall motion abnormalities, acute segmental damaged fraction by T2W and LGE and mean segmental T1 values was performed on matching short axis slices. LGE and improvement in regional wall motion at 6M were also obtained.ResultsWe found that the variability of T1 measurements was significantly lower compared to T2W and that, while the diagnostic performance of acute T1-mapping for detecting myocardial injury was at least as good as that of T2W-CMR in STEMI patients, it was superior to T2W imaging in NSTEMI. There was a significant relationship between the segmental damaged fraction assessed by either by LGE or T2W, and mean segmental T1 values (P < 0.01). The index of salvaged myocardium derived by acute T1-mapping and 6M LGE was not different to the one derived from T2W (P = 0.88). Furthermore, the likelihood of improvement of segmental function at 6M decreased progressively as acute T1 values increased (P < 0.0004).ConclusionsIn acute MI, pre-contrast T1-mapping allows assessment of the extent of myocardial damage. T1-mapping might become an important complementary technique to LGE and T2W for identification of reversible myocardial injury and prediction of functional recovery in acute MI.

【 授权许可】

Unknown   
© Dall'Armellina et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.