Motivation: Hemorrhagic myocardial infarction (hMI) increases the risk of adverse cardiovascular outcomes. Accurate quantification of iron within hMI is critical for improving diagnosis and therapy. Goal(s): However, the coexistence of iron and edema makes reliable iron quantification challenging. A new motion-robust cardiac HDR-QSM technique has been developed to quantify iron in hMI while reducing confounders associated with conventional R2* (1/T2*) methods. Approach: This study investigated the difference between HDR-QSM and R2* in acute and chronic hMI and the influence of myocardial edema on accurate iron quantification. Results: We demonstrated that confounder-corrected cardiac QSM enhances iron sensitivity while reducing edema's confounding impact on hMI. Impact: Cardiac QSM can quantify iron content within hMI, with greater sensitivity and accuracy in the presence of myocardial edema than R2* MRI. HDR-QSM may support reliable iron measurement in studies testing therapies against iron's adverse post-hMI effects.
Huang et al. (Tue,) studied this question.