T₁ mapping for assessment of myocardial injury and microvascular obstruction at one week post myocardial infarction

Cameron, Donnie ORCID: https://orcid.org/0000-0001-9841-6909, Siddiqi, Nishat, Neil, Christopher J, Jagpal, Baljit, Bruce, Margaret, Higgins, David M, He, Jiabao, Singh, Satnam, Redpath, Thomas W, Frenneaux, Michael P and Dawson, Dana K (2016) T₁ mapping for assessment of myocardial injury and microvascular obstruction at one week post myocardial infarction. European Journal of Radiology, 85 (1). pp. 279-285. ISSN 0720-048X

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OBJECTIVES: To compare 3T T1 mapping to conventional T2-weighted (T2W) imaging for delineating myocardial oedema one week after ST-elevation myocardial infarction (STEMI), and to explore the confounding effects of microvascular obstruction (MVO) on each technique.  METHODS: T2W spectral attenuated inversion recovery and native T1 mapping were applied in 10 healthy volunteers and 62 STEMI patients, and late gadolinium enhancement was included for infarct localisation at 1 week and at 6 months post-STEMI. Segmental T1 values and T2W signal intensity ratios were calculated; oedema volumes and salvage indices were determined in patients using image thresholding-a receiver operator characteristic (ROC) derived T1 threshold, and a 2SD T2W threshold; and the results were compared between patients with/without MVO (n=35/27).  RESULTS: Native T1 mapping delineated oedema with significantly better discriminatory power than T2W-as indicated by ROC analysis (area-under-the-curve, AUC=0.89 versus 0.83, p=0.009; and sensitivity/specificity=83/83% versus 73/73%). The optimal ROC threshold derived for T1 mapping was 1241ms, which gave significantly larger oedema volumes than 2SD T2W (p=0.006); with this threshold, patients with and without MVO showed similar oedema volumes, but patients with MVO had significantly poorer salvage indices (p<0.05) than those without. Neither method was significantly affected by MVO, the volume of which was seen to increase exponentially with infarct size.  CONCLUSIONS: Native T1 mapping at 3T can delineate oedema one week post-STEMI, showing larger oedema volumes and better discriminatory power than T2W imaging, and it is suitable for quantitative thresholding. Both techniques are robust against MVO-related magnetic susceptibility.

Item Type: Article
Additional Information: Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Uncontrolled Keywords: acute myocardial infarction,magnetic resonance imaging,myocardium at risk,myocardial oedema,microvascular obstruction,t1 mapping
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health
Faculty of Medicine and Health Sciences > Research Centres > Population Health
Depositing User: Pure Connector
Date Deposited: 10 May 2017 05:05
Last Modified: 19 Oct 2023 01:58
URI: https://ueaeprints.uea.ac.uk/id/eprint/63423
DOI: 10.1016/j.ejrad.2015.10.008


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