Diagnostic Performance of Dark-Blood T2-Weighted CMR for Evaluation of Acute Myocardial Injury

Srichai, Monvadi B.; Lim, Ruth; Lath, Narayan; Babb, James S.; Axel, Leon; Kim, Daniel

doi:10.1097/rli.0b013e3182718672

Cited by 17 publications

(23 citation statements)

References 2 publications

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“…However T2w-TSE imaging has inherent disadvantages that can compromise image quality and oedema detection. Upto 30% of datasets are non-analysable in studies[ 24 , 143 , 144 ]. New T2w sequences have been studied, with encouraging results (Figure 7 ).…”

Section: Ischaemic Aar and Myocardial Salvage In Amimentioning

confidence: 99%

“…It could be argued that since MSI adjusts IS for the extent of AAR, it may have less inherent variability than IS. Since up to 30% of AAR datasets have been deemed non-diagnostic in previous studies[ 24 , 143 , 144 ], this may impact on the robustness of MSI quantification whereas IS datasets are exceptionally rarely excluded based on image quality. It is not clear currently whether IS or MSI is the better measure of revascularisation success post PPCI.…”

Section: Ischaemic Aar and Myocardial Salvage In Amimentioning

confidence: 99%

“…This can lead to subjectivity and dependence upon optimal nulling of normal myocardium and thus potential for error. In addition, commonly used T2w-TSE sequences suffer from non-diagnostic image quality in upto 30% of patients[ 24 , 143 , 144 ].…”

Section: T1 T2 and T2* Quantification And Mapping In Amimentioning

confidence: 99%

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Cardiovascular magnetic resonance imaging assessment of outcomes in acute myocardial infarction

Khan¹,

McCann²

2017

WJC

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Cardiovascular magnetic resonance (CMR) imaging uniquely characterizes myocardial and microvascular injury in acute myocardial infarction (AMI), providing powerful surrogate markers of outcomes. The last 10 years have seen an exponential increase in AMI studies utilizing CMR based endpoints. This article provides a contemporary, comprehensive review of the powerful role of CMR imaging in the assessment of outcomes in AMI. The theory, assessment techniques, chronology, importance in predicting left ventricular function and remodelling, and prognostic value of each CMR surrogate marker is described in detail. Major studies illustrating the importance of the markers are summarized, providing an up to date review of the literature base in CMR imaging in AMI.

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Section: Ischaemic Aar and Myocardial Salvage In Amimentioning

confidence: 99%

Section: Ischaemic Aar and Myocardial Salvage In Amimentioning

confidence: 99%

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Cardiovascular magnetic resonance imaging assessment of outcomes in acute myocardial infarction

Khan¹,

McCann²

2017

WJC

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“…T2-weighted (T2w) CMR sequences are helpful to detect increased in vivo myocardial water content and offer a noninvasive tool to differentiate between acute and chronic disease [5]. T2w dark-blood sequences are currently used and widely accepted [6]. However, this sequence type can suffer from signal loss in higher heart rates and poor contrast between myocardium and blood in areas of insufficient blood signal suppression [7,8].…”

Section: Introductionmentioning

confidence: 99%

Cardiac T2 mapping: robustness and homogeneity of standardized in-line analysis

Wiesmueller

Wuest

Heiß

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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Background and purpose: Interpretation of T2 values remains difficult due to limited comparability across hardware and software systems and the lack of validated measurement recommendations for the number and orientation of mandatory slices. Our aims were to provide a standardized comparison of intra-and inter-individual T2 values in the short and long axes and to investigate inter-scanner reproducibility. Method and materials: Ninety cardiovascular magnetic resonance (CMR) studies in 30 healthy subjects were performed with three identical 1.5 T CMR scanners (same hardware and software) using a balanced steady-state free precession (bSSFP) gradient echo sequence in three short axis (SAx) and three long axis (LAx) views. A commercially available T2 mapping software package of the latest generation with automatic in-line motion correction was used for acquisition. Regions of interest were manually drawn in each of the 16 myocardial segments according to the American Heart Association (AHA) model in three SAx and three LAx acquisitions. Analysis of inter-scanner, intersegmental, intra-segmental, interregional and inter-level differences was performed. Results: Inter-scanner reproducibility was high and the mean myocardial T2 value for all evaluated segments was 45.7 ± 3.4 ms. Significant inter-segmental variations of mean T2 values were found. Mean intra-segmental T2 values were comparable between LAx and SAx acquisitions in 72%. Significantly higher T2 values were found in apical segments and a significant disparity among different regions was found for SAx and LAx orientations. Conclusion: Standardized cardiac T2 mapping is highly reproducible on identical CMR systems. T2 values vary significantly between single heart segments, regions, levels, and axes in young, healthy subjects.

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“…If cut-off values > 1.9 were used for the T2 ratio in the studies, sensitivity values of 45 -100 % and specificity values of 50 -100 % were obtained ( • " Table 11), the variations probably being attributable to the different scanner types and sequences [3,16]. Srichai et al [30] therefore demonstrated a high specificity but overall a low sensitivity for the diagnostic performance of T2-weighted CMR in the evaluation of acute myocardial injury (FSE-SPAIR: sensitivity 29 %, specificity 93 %, PPV 67 %, NPV 73 %; FSE-SPIR: sensitivity 38 %, specificity 91 %, PPV 67 %, NPV 75 %, with no difference in accuracy between the techniques). Surely the role of isolated T2-weighted imaging has to be recognized as limited in the diagnosis of myocarditis.…”

Section: Tissue Characterizationmentioning

confidence: 99%

Functional and Morphological Parameters with Tissue Characterization of Cardiovascular Magnetic Imaging in Clinically Verified “Infarct-like Myocarditis”

Schwab¹,

Rogg²,

Pauschinger³

et al. 2015

Fortschr Röntgenstr

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Purpose: Cardiac magnetic resonance (CMR) has increasingly proved to be a valuable diagnostic tool for evaluating patients with suspected myocarditis. The objective of this study was to evaluate the diagnostic value of functional and morphological parameters including tissue characterization in patients with ?infarct-like myocarditis?. Materials and Methods: 43 patients with clinically verified cases of ?infarct-like myocarditis? (median time to MRI scanning after admission for acute symptoms 3 days) and 35 control patients matched by age and sex were included in this retrospective case control study. In this study we used a 1.5?T MRI scanner conducting steady-state-free-precession sequences, T2-weighted imaging, T1-weighted imaging before and after contrast administration and late gadolinium enhancement sequences. According to the recommendations for CMR diagnosis of myocarditis (Lake Louise consensus criteria), a scan was positive for acute myocarditis if 2 of 3 CMR criteria were present. Results: 30?% of the patients with ?infarct-like myocarditis? had a reduced left ventricular ejection fraction, 11?% had an increased LV end-diastolic volume index and 35?% had an increased LV mass index. The sensitivity of wall motion abnormalities was 63?% with a regional distribution in 49?%. In 47?% of cases regional wall motion abnormalities were present in the lateral left ventricular segments. Pericardial effusions were discovered in 65?% of cases with a circular appearance in 21?% and focal manifestation in 44?%. The diagnostic sensitivity, specificity, and accuracy of CMR in patients with ?infarct-like myocarditis? were 67?%, 100?% and 82?%, respectively. The LGE alone was the most sensitive test parameter with 86?%, providing a specificity of 100?% and accuracy of 92?%. Conclusion: Our study results can be applied to the subgroup of patients with ?infarct-like myocarditis?, where we found that LGE alone was the most sensitive test parameter. In addition to tissue characterization, the functional and morphological analysis of patients with acute myocarditis provides a useful further diagnostic tool. Key Points: ??Infarct-like myocarditis can be diagnosed by CMR with high validity and reliability. ??LGE allone performed best with a sensitivity of 86?%. ??Functional and morphological CMR parameters in addition to tissue characterization are useful tool in the diagnosis of acute myocarditis. Citation Format: ??Schwab J, Rogg H-J, Pauschinger M et?al. Functional and Morphological Parameters with Tissue Characterization of Cardiovascular Magnetic Imaging in Clinically Verified ?Infarct-like Myocarditis?. Fortschr R?ntgenstr 2016; 188: 365???373

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Diagnostic Performance of Dark-Blood T2-Weighted CMR for Evaluation of Acute Myocardial Injury

Cited by 17 publications

References 2 publications

Cardiovascular magnetic resonance imaging assessment of outcomes in acute myocardial infarction

Cardiovascular magnetic resonance imaging assessment of outcomes in acute myocardial infarction

Cardiac T2 mapping: robustness and homogeneity of standardized in-line analysis

Functional and Morphological Parameters with Tissue Characterization of Cardiovascular Magnetic Imaging in Clinically Verified “Infarct-like Myocarditis”

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