Key result
Dual-contrast fast spin-echo MRI signal decay time differentiated infarcted from remote myocardial segments (82 vs 62 msec, P<0.0001), proving superior to T2 ratio for edema detection.
Why the study?
Does dual-contrast fast spin-echo (dcFSE) MRI improve the detection of myocardial edema compared to single-contrast FSE in patients with acute myocardial infarction?
Observational (n=32)
Does dual-contrast fast spin-echo (dcFSE) MRI improve the detection of myocardial edema compared to single-contrast FSE in patients with acute myocardial infarction?
Dual-contrast fast spin-echo MRI provides superior detection of high-grade and diffuse myocardial edema compared to standard single-contrast T2 ratio imaging.
dcFSE MRI may aid edema detection in acute MI; hypothesis-generating and should not yet change practice.
PURPOSE: To introduce a dual-contrast fast spin-echo (dcFSE) sequence for signal decay mapping of myocardial edema. MATERIALS AND METHODS: After consultation with the Institutional Review Board, 22 acute myocardial infarction (MI) patients were examined with magnetic resonance imaging (MRI) at 1.5T 2 days after revascularization. Edema was evaluated in 16 myocardial segments with an exponential fit for signal decay time (SDT) in dcFSE mapping and T2 signal intensity ratio for single-contrast FSE. Myocardial viability was evaluated in late gadolinium enhancement (LGE). A control group of 10 volunteers was examined for edema imaging. SDT was compared in segment groups: 1) with LGE in MI, 2) penumbra, 3) remote from LGE, 4) controls. Groups 1/3 and 3/4 were tested on difference. Three phantoms providing similar T2 but different T1 relaxation times (low, intermediate, high) were examined with dcFSE and multicontrast spin echo sequence as a reference. RESULTS: The SDT/T2 ratio for segment groups was 1) 82msec/1.7 in segments with LGE; 2) 65msec/1.6 for penumbra, 3) 62msec/1.7 for remote segments, and 4) 50msec/1.6 in controls. In dcFSE group 1/3 (P < 0.0001) and in group 3/4 (P = 0.0002) SDT was significantly different. In single-contrast FSE the T2 ratio was not significantly different for both tests: 1/3 P = 0.1889; 3/4 P = 0.8879. T2 -overestimation of dcFSE was 23% in low, 29% in intermediate, and 35% in highly T1 contaminated phantoms. CONCLUSION: dcFSE signal decay edema mapping is feasible in volunteers and patients. DcFSE SDT is superior to T2 ratio for detection of high-grade and diffuse myocardial edema. J. Magn. Reson. Imaging 2016;44:186-193.
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Krumm et al. (2015) conducted an observational in Acute myocardial infarction (n=32). Dual-contrast fast spin-echo (dcFSE) MRI vs. Single-contrast FSE / healthy controls was evaluated on Signal decay time (SDT) difference between infarcted (LGE) and remote myocardial segments (p=<0.0001). Dual-contrast fast spin-echo MRI signal decay time differentiated infarcted from remote myocardial segments (82 vs 62 msec, P<0.0001), proving superior to T2 ratio for edema detection.
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