Native T1-mapping accurately delineated the edema-based area-at-risk compared to T2-mapping (41.6% vs 41.7% LV, P=0.72), and post-contrast T1-mapping accurately quantified acute MI size.
Observational (n=28)
No
Does T1-mapping accurately quantify area-at-risk and infarct size compared to conventional T2-mapping and LGE in STEMI patients?
T1-mapping can accurately quantify both edema-based area-at-risk and acute infarct size in STEMI patients, potentially shortening CMR scan duration by 15-20 minutes.
Estimación del efecto: ICC 0.986 (95% CI 0.969-0.993)
Tasa de eventos absoluta: 41.6% vs 41.7%
valor p: p=0.72
BACKGROUND: A comprehensive cardiovascular magnetic resonance (CMR) in reperfused ST-segment myocardial infarction (STEMI) patients can be challenging to perform and can be time-consuming. We aimed to investigate whether native T1-mapping can accurately delineate the edema-based area-at-risk (AAR) and post-contrast T1-mapping and synthetic late gadolinium (LGE) images can quantify MI size at 1.5 T. Conventional LGE imaging and T2-mapping could then be omitted, thereby shortening the scan duration. METHODS: Twenty-eight STEMI patients underwent a CMR scan at 1.5 T, 3 ± 1 days following primary percutaneous coronary intervention. The AAR was quantified using both native T1 and T2-mapping. MI size was quantified using conventional LGE, post-contrast T1-mapping and synthetic magnitude-reconstructed inversion recovery (MagIR) LGE and synthetic phase-sensitive inversion recovery (PSIR) LGE, derived from the post-contrast T1 maps. RESULTS: 0.97; ICC 0.986 (0.969-0.993); bias -0.1 ± 4.2% LV). There were excellent correlation and inter-method agreement with no bias, between MI size by conventional LGE, synthetic MagIR LGE (bias 0.2 ± 2.2%LV, P = 0.35), synthetic PSIR LGE (bias 0.4 ± 2.2% LV, P = 0.060) and post-contrast T1-mapping (bias 0.3 ± 1.8% LV, P = 0.10). The mean scan duration was 58 ± 4 min. Not performing T2 mapping (6 ± 1 min) and conventional LGE (10 ± 1 min) would shorten the CMR study by 15-20 min. CONCLUSIONS: T1-mapping can accurately quantify both the edema-based AAR (using native T1 maps) and acute MI size (using post-contrast T1 maps) in STEMI patients without major cardiovascular risk factors. This approach would shorten the duration of a comprehensive CMR study without significantly compromising on data acquisition and would obviate the need to perform T2 maps and LGE imaging.
Bulluck et al. (Jue,) realizaron una observación en infarto de miocardio con elevación del segmento ST (n=28). Se evaluó el mapeo nativo de T1 frente al mapeo de T2 en el área en riesgo (% del ventrículo izquierdo) (ICC 0.986, 95% IC 0.969-0.993, p=0.72). El mapeo nativo de T1 delineó con precisión el área en riesgo basada en edema en comparación con el mapeo de T2 (41.6% frente a 41.7% del VI, P=0.72), y el mapeo de T1 post-contraste cuantificó con precisión el tamaño del infarto agudo.