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Published on: August 17, 2022
Free-breathing MRI for the assessment of myocardial infarction: clinical validation
Harrie C M van den Bosch1, Jos J M Westenberg, Johannes C Post
1Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands. harrie.vd.bosch@cze.nl
Objective:
The objective of our study was to validate free-breathing 2D inversion recovery delayed-enhancement MRI for the assessment of myocardial infarction compared with a breath-hold 3D technique.
Subjects And Methods:
Institutional review board approval and written informed consent were obtained. Thirty-two patients (25 men, seven women; mean age, 68 years; age range, 39-84 years) underwent breath-hold gradient-echo 3D inversion-recovery delayed-enhancement MRI and free-breathing respiratory-triggered 2D inversion-recovery delayed-enhancement MRI of the heart (scanning time, 50-80 seconds). Infarct size was quantitatively analyzed as a percentage of the left ventricle. The location and transmural extent of myocardial infarction were assessed by visual scoring. Intraclass correlation and Bland-Altman analysis were used to evaluate the agreement between the techniques for infarct quantification. Kappa statistics were used to analyze the visual score.
Results:
Excellent agreement between the two techniques was observed for infarct quantification (intraclass correlation = 0.99 [p < 0.01]; mean difference +/- SD = 0.32% +/- 2.4%). The agreement in assessing transmural extent of infarction was good to excellent between the free-breathing technique and the 3D breath-hold technique (kappa varied between 0.70 and 0.96 for all segments). No regions of infarction were missed using the free-breathing approach.
Conclusion:
The free-breathing 2D delayed-enhancement MRI sequence is a fast and reliable tool for detecting myocardial infarction.
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