Diffusion-weighted echo planar imaging in patients with recent myocardial infarction

ObjectiveTo evaluate a diffusion-weighted (DW) black blood MR sequence for the detection of myocardium signal abnormalities in patients with recent myocardial infarction (MI).MethodsA DW black blood EPI sequence was acquired at 1.5 T in 12 patients with recent MI. One slice per patient was acquired with b = 0 and b = 50 s/mm2. A standard short tau inversion recovery (STIR) T2-weighted sequence was acquired at the same level. Viability was assessed with delayed-enhancement sequences. Images were analyzed qualitatively and quantitatively. A non parametric Wilcoxon test was used for statistical analysis, with a significance level of P < .05.ResultsThe mean quality of blood suppression was higher on DW EPI images than on STIR T2-weighted images (3.9 ± 0.3 and 3.0 ± 0.7, respectively; P = 0.01). Myocardial high signal areas were detected in respectively 100% (12/12) and 67% (8/12) of the patients on DW EPI and STIR T2-weighted images. The four patients (33%) with false-negative STIR T2 findings all had high signal areas on DW EPI images corresponding to the location of the MI on the delayed-enhanced images.ConclusionDW EPI sequences are a feasible alternative to standard STIR T2-weighted sequences for detecting myocardium high signal areas in patients with recent MI.

[1]  M. Moseley,et al.  Yield of diffusion-weighted MRI for detection of potentially relevant findings in stroke patients , 2000, Neurology.

[2]  R. Steeds,et al.  T2-weighted magnetic resonance imaging to assess myocardial oedema in ischaemic heart disease , 2009, Heart.

[3]  Denis Le Bihan,et al.  Intravoxel incoherent motion perfusion MR imaging: a wake-up call. , 2008, Radiology.

[4]  D R Pickens,et al.  Magnetic resonance perfusion/diffusion imaging of the excised dog kidney. , 1992, Investigative radiology.

[5]  D. Le Bihan,et al.  Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. , 1988, Radiology.

[6]  Liver imaging at 3.0 T: diffusion-induced black-blood echo-planar imaging with large anatomic volumetric coverage as an alternative for specific absorption rate-intensive echo-train spin-echo sequences: feasibility study. , 2008, Radiology.

[7]  Han Wen,et al.  In vivo study of microcirculation in canine myocardium using the IVIM method † , 2003, Magnetic resonance in medicine.

[8]  Yu-Chung N. Cheng,et al.  Magnetic Resonance Imaging: Physical Principles and Sequence Design , 1999 .

[9]  Volker Rasche,et al.  Local excitation black blood imaging at 3T: Application to the carotid artery wall , 2008, Magnetic resonance in medicine.

[10]  E. McVeigh,et al.  T2‐prepared SSFP improves diagnostic confidence in edema imaging in acute myocardial infarction compared to turbo spin echo , 2007, Magnetic resonance in medicine.

[11]  R. Dinsmore,et al.  Imaging myocardial fiber architecture in vivo with magnetic resonance , 1995, Magnetic resonance in medicine.

[12]  J J Neil,et al.  An evaluation of the sensitivity of the intravoxel incoherent motion (IVIM) method of blood flow measurement to changes in cerebral blood flow , 1994, Magnetic resonance in medicine.

[13]  R. McKinstry,et al.  Principles and applications of echo-planar imaging: a review for the general radiologist. , 2001, Radiographics : a review publication of the Radiological Society of North America, Inc.

[14]  Keith Heberlein,et al.  Evaluation of optimized inversion‐recovery fat‐suppression techniques for T2‐weighted abdominal MR imaging , 2008, Journal of Magnetic Resonance Imaging.

[15]  A closer look on the battlefield: the salvaged area at risk as an outcome marker for myocardial reperfusion. , 2009, JACC. Cardiovascular imaging.

[16]  Timothy J Carroll,et al.  Three-dimensional black-blood MR imaging of carotid arteries with segmented steady-state free precession: initial experience. , 2007, Radiology.

[17]  Orlando Simonetti,et al.  T2‐weighted cardiovascular magnetic resonance imaging , 2007, Journal of magnetic resonance imaging : JMRI.

[18]  Debiao Li,et al.  Diffusion-prepared segmented steady-state free precession: Application to 3D black-blood cardiovascular magnetic resonance of the thoracic aorta and carotid artery walls. , 2007, Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance.

[19]  O. Simonetti,et al.  "Black blood" T2-weighted inversion-recovery MR imaging of the heart. , 1996, Radiology.

[20]  Han Wen,et al.  Detection of myocardial capillary orientation with intravascular iron‐oxide nanoparticles in spin‐echo MRI , 2006, Magnetic resonance in medicine.

[21]  A. Arai.  Using magnetic resonance imaging to characterize recent myocardial injury: utility in acute coronary syndrome and other clinical scenarios. , 2008, Circulation.

[22]  J. Schulz-Menger,et al.  The salvaged area at risk in reperfused acute myocardial infarction as visualized by cardiovascular magnetic resonance. , 2008, Journal of the American College of Cardiology.

[23]  Myocardial edema imaging of the area at risk in acute myocardial infarction: seeing through water. , 2009, JACC. Cardiovascular imaging.

[24]  R. F. Hoyt,et al.  Cardiac magnetic resonance imaging , 2004, Postgraduate Medical Journal.

[25]  M. Friedrich.  Tissue characterization of acute myocardial infarction and myocarditis by cardiac magnetic resonance. , 2008, JACC. Cardiovascular imaging.

[26]  A. Luciani,et al.  Liver Cirrhosis : Intravoxel Incoherent Motion MR Imaging — Pilot Study 1 , 2008 .

[27]  J. Kurhanewicz,et al.  Diffusion-weighted MR imaging of acute stroke: correlation with T2-weighted and magnetic susceptibility-enhanced MR imaging in cats. , 1990, AJNR. American journal of neuroradiology.

[28]  Pascal Spincemaille,et al.  Effective motion‐sensitizing magnetization preparation for black blood magnetic resonance imaging of the heart , 2008, Journal of magnetic resonance imaging : JMRI.

[29]  J. Tyberg,et al.  Edema as a very early marker for acute myocardial ischemia: a cardiovascular magnetic resonance study. , 2009, Journal of the American College of Cardiology.

[30]  J. Schulz-Menger,et al.  Delayed Enhancement and T2-Weighted Cardiovascular Magnetic Resonance Imaging Differentiate Acute From Chronic Myocardial Infarction , 2004, Circulation.

[31]  M. Moseley,et al.  Diffusion-weighted MR imaging in acute ischemia: value of apparent diffusion coefficient and signal intensity thresholds in predicting tissue at risk and final infarct size. , 2004, AJNR. American journal of neuroradiology.