Experimental validation of contrast-enhanced SSFP cine CMR for quantification of myocardium at risk in acute myocardial infarction

Figures

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  Fig. 1. Myocardium at risk (MaR) is shown to have similar extent with ex-vivo CE-SSFP (top row) and MPS (bottom row) in matched slices from the same heart. The green line denotes epicardium, the red line endocardium and the white line MaR. MPS = myocardial perfusion single photon emission tomography

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  Fig. 2. Myocardium at risk (MaR) by MRI and MPS show overall good correlation and agreement. Panel a shows a good correlation between MaR by ex-vivo CE-SSFP and MaR by myocardial perfusion SPECT (MPS). The corresponding Bland-Altman plot in panel b shows a low bias. Panel c shows a good correlation between MaR by ex-vivo CE-SSFP and MaR by in-vivo CE-SSFP, with a low bias (panel d). Panel e shows a good correlation between MaR by in-vivo CE-SSFP and MaR by MPS. The corresponding Bland-Altman plot in panel f shows a low bias. In all cases, MaR is expressed as percent of left ventricular mass. The dotted lines in a, c and e represent the line of identity

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  Fig. 3. Infarct and myocardium at risk (MaR) in vivo and ex vivo. The upper row shows infarct by late gadolinium enhancement (LGE) and MaR by CE-SSFP in vivo and the lower row shows infarct by high-resolution T1-weighted imaging and MaR by CE-SSFP ex vivo. Note the significantly larger MaR compared to infarction both in vivo and ex vivo

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  Fig. 4. Myocardium at risk (MaR) by CE-SSFP at various time points after contrast agent administration. The upper row shows CE-SSFP at the end-diastolic (ED) time-frame and the bottom row at the end-systolic (ES) time-frame. The green line denotes epicardium, the red line endocardium and the white line MaR. Note that there is no change in the extent of MaR over time. Note also that there is a hypointense core within MaR at 3 min not visible at later timepoints. This could be due to slower contrast filling to this area, possibly because of microvascular obstruction

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  Fig. 5. Myocardium at risk (MaR) by CE-SSFP over time after contrast agent administration in single midventricular slices. There was no change in MaR up to 30 min after contrast agent administration (p = 0.95)