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[Detection of recent myocardial infarction by spin-echo MRI. Value of the third echo]
Abstract:
Seventeen patients underwent MRI spin-echo imaging (Magniscan 5000) 7 to 21 days after acute myocardial infarction (10 anterior, 7 inferior--average 13.1 +/- 3.7 days). The success rate of visualisation of AMI evaluated independently by a qualitative score (from 0 to 4) based on the brilliance of the myocardial signal after taking steps to eliminate the brillance of pericardial fat and subendocardial flow signals, was 3.1 +/- 0.87 in anterior AMI (10 out of 10) and 1.28 +/- 1.25 (4 out of 7) in inferior AMI (p less than 0.007). The diagnostic sensitivity was increased when images of the third echo were used (13 out of 17) compared to those of the second echo (8 out of 17, p less than 0.016). The value of the 3rd echo is explained and emphasised. Abnormal intramyocardial signals were not recorded in a control group of 10 patients under similar conditions of multi-echo imaging. Finally, significant correlations were observed between peak CPK concentrations and the MRI score (r = 0.62; p less than 0.01) and between peak CPK and the number of sections in which the hyperbrilliant signal was observed (r = 0.74; p less than 0.001): this may open the day to quantification of myocardial necrosis by MRI.
Insights
Magnetic Resonance Imaging (MRI) effectively visualizes acute myocardial infarction (AMI), especially anterior AMIs. Utilizing the third echo in multi-echo imaging significantly improves diagnostic sensitivity for detecting myocardial damage.
Area of Science:
- Cardiovascular Imaging
- Medical Diagnostics
- Biomarkers
Context:
- Acute myocardial infarction (AMI) diagnosis relies on clinical, electrocardiographic, and biochemical markers.
- Magnetic Resonance Imaging (MRI) offers non-invasive visualization of cardiac tissue.
- Evaluating MRI's efficacy in detecting myocardial necrosis post-AMI is crucial.
Purpose:
- To assess the success rate and diagnostic sensitivity of MRI spin-echo imaging in visualizing acute myocardial infarction.
- To determine the optimal echo sequence for improved visualization of myocardial damage.
- To explore correlations between MRI findings and biochemical markers of myocardial injury.
Summary:
- Seventeen patients with acute myocardial infarction (AMI) underwent MRI spin-echo imaging 7-21 days post-infarction.
- Visualization scores were significantly higher for anterior AMIs (3.1) than inferior AMIs (1.28).
- Diagnostic sensitivity increased with the third echo (13/17 patients) compared to the second echo (8/17 patients).
- MRI scores correlated significantly with peak creatine phosphokinase (CPK) levels, suggesting potential for quantifying myocardial necrosis.
Impact:
- MRI spin-echo imaging demonstrates high success in visualizing anterior AMIs.
- The third echo in multi-echo imaging enhances diagnostic sensitivity for myocardial infarction.
- MRI findings correlate with CPK levels, indicating potential for quantitative assessment of myocardial necrosis.