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Detection of myocardial edema with low-b-value diffusion-weighted echo-planar imaging sequence in patients with acute

Julien Potet1, Alain Rahmouni, Julie Mayer

  • 1Departments of Radiology and Cardiology, Henri Mondor Hospital, University Paris Est Creteil, Assistance Publique-Hôpitaux de Paris, 51 av Mal de Lattre de Tassigny, 94000 Creteil, France; Siemens Healthcare, Saint Denis, France.

Radiology
|May 23, 2013
PubMed
Abstract

Insights

Low-b-value diffusion-weighted (DW) echo-planar (EP) imaging effectively detects myocardial edema in acute myocarditis patients. This technique offers higher sensitivity and accuracy than standard STIR T2-weighted imaging for diagnosing this condition.

Area of Science:

  • Cardiovascular Imaging
  • Medical Diagnostics
  • Biomedical Engineering

Background:

  • Acute myocarditis diagnosis relies on imaging techniques to detect myocardial edema.
  • Standard methods like STIR T2-weighted imaging have limitations in sensitivity and accuracy.
  • Novel imaging sequences are needed to improve the detection of myocardial inflammation.

Purpose of the Study:

  • To assess the performance of a low-b-value diffusion-weighted (DW) echo-planar (EP) imaging sequence.
  • To evaluate its efficacy in detecting regional and diffuse myocardial edema.
  • To compare its effectiveness against standard STIR T2-weighted imaging in acute myocarditis patients.

Main Methods:

  • Thirteen acute myocarditis patients and seven healthy controls underwent low-b-value (50 sec/mm(2)) DW cardiac MRI.
  • DW EP images were acquired and analyzed qualitatively and quantitatively.
  • STIR T2-weighted and late gadolinium enhancement (LGE) images were used for comparison, with LGE as the reference standard.

Main Results:

  • DW EP imaging detected myocardial high-signal-intensity areas in 100% of myocarditis patients, compared to 38% for STIR T2-weighted.
  • 61% of high-signal-intensity areas on DW EP were not seen on STIR T2-weighted but colocalized with LGE findings.
  • DW EP demonstrated significantly higher global myocardial signal intensity ratio (P = .03) and superior sensitivity (92%) and accuracy (95%) compared to STIR T2-weighted (54% and 70%).

Conclusions:

  • Low-b-value DW EP imaging is a feasible and effective alternative to STIR T2-weighted imaging.
  • It enhances the detection of myocardial edema in acute myocarditis.
  • This sequence offers improved diagnostic performance for regional and global myocardial edema.

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