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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Detecting Acute Myocardial Infarction by Diffusion-Weighted versus T2-Weighted Imaging and Myocardial Necrosis

Jiyang Jin, Min Chen, Yongjun Li

    Texas Heart Institute Journal
    |October 26, 2016
    PubMed

    Insights

    Diffusion-weighted imaging (DWI) detects early myocardial signal abnormalities in acute myocardial infarction. This technique identifies infarction earlier than T2-weighted imaging (T2WI) and serum biomarkers in porcine models.

    Area of Science:

    • Cardiovascular Imaging
    • Magnetic Resonance Imaging
    • Myocardial Infarction Research

    Background:

    • Acute myocardial infarction (AMI) diagnosis relies on timely and accurate detection of ischemic myocardium.
    • Current imaging and serologic markers have limitations in early detection of AMI.
    • Diffusion-weighted imaging (DWI) shows potential for assessing tissue water content changes in ischemia.

    Purpose of the Study:

    • To evaluate the signal evolution of ischemic myocardium using diffusion-weighted magnetic resonance imaging (DWI) in an acute myocardial infarction model.
    • To compare the early detection capabilities of DWI against T2-weighted imaging (T2WI) and serum myocardial necrosis markers.

    Main Methods:

    • A porcine model of acute myocardial infarction was created via coronary artery occlusion.
    • Diffusion-weighted imaging (DWI), T2-weighted imaging (T2WI), and late gadolinium enhancement imaging were performed at multiple time points.
    • Serum markers (myoglobin, CK-MB, troponin I) and histochemical staining were used for injury assessment.

    Main Results:

    • Diffusion-weighted imaging (DWI) identified myocardial signal abnormalities earlier (<4 hours) post-infarction compared to T2-weighted imaging (T2WI).
    • DWI detected infarct-related high signal in 87.5% of pigs, versus 37.5% for T2WI (P=0.046).
    • Quantitative analysis showed significant differences in contrast-to-noise ratio and relative signal index on DWI, while serum markers remained largely negative within 4 hours.

    Conclusions:

    • Diffusion-weighted imaging (DWI) is a sensitive technique for early detection of myocardial signal abnormalities following acute myocardial infarction.
    • DWI identifies infarction earlier than T2-weighted imaging (T2WI) and conventional clinical serologic biomarkers.
    • DWI holds promise for rapid diagnosis and assessment of acute myocardial infarction.
    Keywords:
    Diffusion magnetic resonance imagingdisease models/animalfeasibility studiesimage enhancement/methodsmagnetic resonance imaging/methodsmyocardial infarction/diagnosis/physiopathologymyocardium/pathologypredictive value of testssignal-to-noise ratioswine

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