Diagnostic performance of T₁ and T₂ mapping to detect intramyocardial hemorrhage in reperfused ST‐segment elevation myocardial infarction (STEMI) patients

Purpose To investigate the performance of T 1 and T 2 mapping to detect intramyocardial hemorrhage (IMH) in ST‐segment elevation myocardial infarction (STEMI) patients treated by primary percutaneous coronary intervention (PPCI). Materials and Methods Fifty STEMI patients were prospectively recruited between August 2013 and July 2014 following informed consent. Forty‐eight patients completed a 1.5T cardiac magnetic resonance imaging (MRI) with native T 1 , T 2 , and maps at 4 ± 2 days. Receiver operating characteristic (ROC) analyses were performed to assess the performance of T 1 and T 2 to detect IMH. Results The mean age was 59 ± 13 years old and 88% (24/48) were male. In all, 39 patients had interpretable maps and 26/39 (67%) of the patients had IMH ( <20 msec on maps). Both T 1 and T 2 values of the hypointense core within the area‐at‐risk (AAR) performed equally well to detect IMH ( T 1 maps AUC 0.86 [95% confidence interval [CI] 0.72–0.99] versus T 2 maps AUC 0.86 [95% CI 0.74–0.99]; P = 0.94). Using the binary assessment of presence or absence of a hypointense core on the maps, the diagnostic performance of T 1 and T 2 remained equally good ( T 1 AUC 0.87 [95% CI 0.73–1.00] versus T 2 AUC 0.85 [95% CI 0.71–0.99]; P = 0.90) with good sensitivity and specificity ( T 1 : 88% and 85% and T 2 : 85% and 85%, respectively). Conclusion The presence of a hypointense core on the T 1 and T 2 maps can detect IMH equally well and with good sensitivity and specificity in reperfused STEMI patients and could be used as an alternative when images are not acquired or are not interpretable. Level of Evidence : 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:877–886