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Performance of two Methods for Cardiac MRI Edema Mapping: Dual-Contrast Fast Spin-Echo and T2 Prepared Balanced
Patrick Krumm1, Petros Martirosian2, Dominik Rath3
1Diagnostic and Interventional Radiology, University of Tübingen, Germany.
Purpose:
To compare true positive and false negative results of myocardial edema mapping in two methods. Myocardial edema may be difficult to detect on cardiac MRI.
Materials And Methods:
76 patients (age 59 ± 11 years, 15 female) with acute myocardial infarction (MI) and 10 healthy volunteers were prospectively included in this single-center study. 1.5 T cardiac MRI was performed in patients 2.5 days after revascularization (median) for edema mapping: Steady State Free Precession (SSFP) mapping sequence with T2-preparation pulses (T2prep); and dual-contrast Fast Spin-Echo (dcFSE) signal decay edema mapping. Late gadolinium enhancement (LGE) was used as the reference for expected edema in acute MI.
Results:
311 myocardial segments in patients were acutely infarcted with mean T2 73 ms for T2prep SSFP vs. 87 ms for dcFSE edema mapping. In healthy volunteers the mean T2 was 56 ms for T2prep SSFP vs. 50 ms for dcFSE edema mapping. Receiver operating characteristic (ROC) curve for T2prep SSFP show area under the curve (AUC) 0.962, p < 0.0001, Youden index J 0.8266, associated criterion > 60 ms, sensitivity 94 %, specificity 89 %. dcFSE ROC AUC 0.979, p < 0.0001, J 0.9219, associated criterion > 64 ms, sensitivity 93 %, specificity 99 %.
Conclusion:
Both edema mapping methods indicate high-grade edema with high sensitivity. Nevertheless, edema in acute infarction may be focally underestimated in both mapping methods.
Key Points:
· Sensitivity for edema detection is high for both methods.. · Edema may be focally underestimated by T2prep SSFP edema mapping and dcFSE mapping..
Citation Format:
· Krumm P, Martirosian P, Rath D et al. Performance of two Methods for Cardiac MRI Edema Mapping: Dual-Contrast Fast Spin-Echo and T2 Prepared Balanced Steady State Free Precession. Fortschr Röntgenstr 2020; 192: 669 - 677.
Insights
This study compared two cardiac MRI methods for detecting myocardial edema after infarction. Both T2prep SSFP and dcFSE edema mapping showed high sensitivity, though focal edema may be underestimated.
Area of Science:
- Cardiovascular Imaging
- Medical Physics
- Radiology
Background:
- Myocardial edema detection on cardiac MRI can be challenging.
- Accurate assessment of myocardial edema is crucial for acute myocardial infarction (MI) management.
Purpose of the Study:
- To compare the true positive and false negative results of two myocardial edema mapping techniques.
- Evaluate the performance of Steady State Free Precession (SSFP) with T2-preparation pulses (T2prep) and dual-contrast Fast Spin-Echo (dcFSE) for edema detection.
Main Methods:
- Prospective inclusion of 76 acute MI patients and 10 healthy volunteers.
- 1.5T cardiac MRI for edema mapping using T2prep SSFP and dcFSE sequences.
- Late gadolinium enhancement (LGE) served as the reference standard for MI-related edema.
Main Results:
- T2prep SSFP showed an AUC of 0.962 (sensitivity 94%, specificity 89%).
- dcFSE demonstrated an AUC of 0.979 (sensitivity 93%, specificity 99%).
- Both methods exhibited high sensitivity for edema detection, with dcFSE showing higher specificity.
Conclusions:
- Both T2prep SSFP and dcFSE edema mapping techniques are highly sensitive for detecting myocardial edema.
- Focal underestimation of edema can occur with both mapping methods in acute infarction.
- dcFSE offers superior specificity in identifying myocardial edema compared to T2prep SSFP.
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