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Detection and quantification of recent myocardial infarction: diagnostic value of multiecho multislice spin echo
1Radiologie B, Hôpital central, Hospitalo-Universitaire de Strasbourg, France.
Abstract:
Thirty-four patients with documented transmural MI were studied with gated three echo, multislice MR imaging. In 12 patients MRI MI size was compared with CK release measurement, Tl-201 SPECT defect, and with Tc-99m LVEF. Infarct was visualised in 29/34 patients on 3rd echo images (18/34 on 2nd and 6/34 on 1st echo images). Mean MR infarct size (planimetered from 3rd echo images): 33.1 +/- 9% overestimated the SPECT defect (mean value of 23.8 +/- 15%). However, the overall correlation between MRI and Tl-201 sizing was significant: r = 0.82; p less than 0.001; SEE = 5.5%. The correlation with LVEF also appeared significant: r = -0.61; p less than 0.038.
Insights
Magnetic resonance imaging (MRI) accurately visualizes myocardial infarction (MI) size, correlating well with thallium-201 SPECT imaging and left ventricular ejection fraction (LVEF). This advanced MRI technique offers a reliable method for assessing infarct size in patients post-MI.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Diagnostics
Background:
- Transmural myocardial infarction (MI) requires accurate size assessment for prognosis and treatment.
- Current imaging modalities like SPECT have limitations in precise infarct sizing.
- Magnetic resonance imaging (MRI) offers high-resolution anatomical detail for cardiac assessment.
Purpose of the Study:
- To evaluate the accuracy of gated, multislice MRI in quantifying transmural myocardial infarction (MI) size.
- To compare MRI-derived infarct size with established methods including CK release, Tl-201 SPECT, and Tc-99m LVEF.
- To determine the correlation between MRI infarct size and left ventricular ejection fraction (LVEF).
Main Methods:
- Thirty-four patients with documented transmural MI underwent gated, multislice MRI.
- Infarct visualization and size were assessed using MRI, with comparisons made to CK levels, Tl-201 SPECT, and Tc-99m LVEF in a subset of patients.
- MRI infarct size was planimetered from third-echo images.
Main Results:
- MRI successfully visualized infarcts in 29 out of 34 patients, with improved detection on later echo images.
- Mean MRI infarct size (33.1 ± 9%) was larger than Tl-201 SPECT defect size (23.8 ± 15%), but showed significant correlation (r = 0.82, p < 0.001).
- A significant correlation was also observed between MRI infarct size and LVEF (r = -0.61, p < 0.038).
Conclusions:
- Gated, multislice MRI is a valuable tool for visualizing and quantifying transmural myocardial infarction (MI) size.
- MRI infarct sizing demonstrates strong correlation with Tl-201 SPECT and significant inverse correlation with LVEF.
- MRI provides a reliable and accurate method for assessing infarct size, aiding in patient management post-myocardial infarction.