T2‐prepared SSFP improves diagnostic confidence in edema imaging in acute myocardial infarction compared to turbo spin echo

T2‐weighted MRI of edema in acute myocardial infarction (MI) provides a means of differentiating acute and chronic MI, and assessing the area at risk of infarction. Conventional T2‐weighted imaging of edema uses a turbo spin‐echo (TSE) readout with dark‐blood preparation. Clinical applications of dark‐blood TSE methods can be limited by artifacts such as posterior wall signal loss due to through‐plane motion, and bright subendocardial artifacts due to stagnant blood. Single‐shot imaging with a T2‐prepared SSFP readout provides an alternative to dark‐blood TSE and may be conducted during free breathing. We hypothesized that T2‐prepared SSFP would be a more reliable method than dark‐blood TSE for imaging of edema in patients with MI. In patients with MI (22 acute and nine chronic MI cases), T2‐weighted imaging with both methods was performed prior to contrast administration and delayed‐enhancement imaging. The T2‐weighted images using TSE were nondiagnostic in three of 31 cases, while six additional cases rated as being of diagnostic quality yielded incorrect diagnoses. In all 31 cases the T2‐prepared SSFP images were rated as diagnostic quality, correctly differentiated acute or chronic MI, and correctly determined the coronary territory. Free‐breathing T2‐prepared SSFP provides T2‐weighted images of acute MI with fewer artifacts and better diagnostic accuracy than conventional dark‐blood TSE. Magn Reson Med 57:891–897, 2007. Published 2007 Wiley‐Liss, Inc.