Cardiovascular magnetic resonance imaging of myocardial oedema following acute myocardial infarction: Is whole heart coverage necessary?. Issue 1 (December 2015)

• Record Type: Journal Article
• Authors: Hamshere, Stephen; Jones, Daniel; Pellaton, Cyril; Longchamp, Danielle; Burchell, Tom; Mohiddin, Saidi; Moon, James; Kastrup, Jens; Locca, Didier; Petersen, Steffen; Westwood, Mark; Mathur, Anthony
• Is Part Of: Journal of cardiovascular magnetic resonance. Volume 18:Issue 1(2016)
• Page Start: 1
• Page End: 9
• Publication Date: 2015-12
• Subjects: Cardiovascular system -- Magnetic resonance imaging -- Periodicals; 616.1207548
• DOI: 10.1186/s12968-016-0226-5
• Languages: English
• ISSNs: 1097-6647

Abstract

Abstract Background AAR measurement is useful when assessing the efficacy of reperfusion therapy and novel cardioprotective agents after myocardial infarction. Multi-slice (Typically 10-12) T2-STIR has been used widely for its measurement, typically with a short axis stack (SAX) covering the entire left ventricle, which can result in long acquisition times and multiple breath holds. This study sought to compare 3-slice T2-short-tau inversion recovery (T2- STIR) technique against conventional multi-slice T2-STIR technique for the assessment of area at risk (AAR). Methods CMR imaging was performed on 167 patients after successful primary percutaneous coronary intervention. 82 patients underwent a novel 3-slice SAX protocol and 85 patients underwent standard 10-slice SAX protocol. AAR was obtained by manual endocardial and epicardial contour mapping followed by a semi- automated selection of normal myocardium; the volume was expressed as mass (%) by two independent observers. Results 85 patients underwent both 10-slice and 3-slice imaging assessment showing a significant and strong correlation (intraclass correlation coefficient = 0.92;p < 0.0001) and a low Bland-Altman limit (mean difference −0.03 ± 3.21 %, 95 % limit of agreement, - 6.3 to 6.3) between the 2 analysis techniques. A further 82 patients underwent 3-slice imaging alone, both the 3-slice and the 10-slice techniques showed statistically significant correlations with angiographic risk scores (3-slice to BARIr = 0.36, 3-slice to APPROACHr = 0.42, 10-slice to BARIr = 0.27, 10-slice to APPROACHr = 0.46). There was low inter-observer variability demonstrated in the 3-slice technique, which was comparable to the 10-slice method (z = 1.035, p = 0.15). Acquisition and analysis times were quicker in the 3-slice compared to the 10-slice method (3-slice median time: 100 seconds (IQR: 65-171 s) vs (10-slice time: 355 seconds (IQR: 275-603 s);p < 0.0001. Conclusions AAR measured using 3-slice T2-STIR technique correlates well with standard 10-slice techniques, with no significant bias demonstrated in assessing the AAR. The 3-slice technique requires less time to perform and analyse and is therefore advantageous for both patients and clinicians.