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Diagnostic Performance of T-1 and T-2 Mapping to Detect Intramyocardial Hemorrhage in Reperfused ST-segment Elevation Myocardial Infarction Patients

Bulluck, H; Rosmini, S; Abdel-Gadir, A; Bhuva, AN; Treibel, TA; Fontana, M; Gonzalez-Lopez, E; ... Hausenloy, DJ; + view all (2017) Diagnostic Performance of T-1 and T-2 Mapping to Detect Intramyocardial Hemorrhage in Reperfused ST-segment Elevation Myocardial Infarction Patients. Journal of Magnetic Resonance Imaging , 46 (3) pp. 877-886. 10.1002/jmri.25638. Green open access

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Abstract

PURPOSE: To investigate the performance of T1 and T2 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 T1, T2, and math formula maps at 4 ± 2 days. Receiver operating characteristic (ROC) analyses were performed to assess the performance of T1 and T2 to detect IMH. RESULTS: The mean age was 59 ± 13 years old and 88% (24/48) were male. In all, 39 patients had interpretable math formula maps and 26/39 (67%) of the patients had IMH ( math formula <20 msec on math formula maps). Both T1 and T2 values of the hypointense core within the area-at-risk (AAR) performed equally well to detect IMH (T1 maps AUC 0.86 [95% confidence interval [CI] 0.72–0.99] versus T2 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 T1 and T2 remained equally good (T1 AUC 0.87 [95% CI 0.73–1.00] versus T2 AUC 0.85 [95% CI 0.71–0.99]; P = 0.90) with good sensitivity and specificity (T1: 88% and 85% and T2: 85% and 85%, respectively). CONCLUSION: The presence of a hypointense core on the T1 and T2 maps can detect IMH equally well and with good sensitivity and specificity in reperfused STEMI patients and could be used as an alternative when math formula images are not acquired or are not interpretable.

Type: Article
Title: Diagnostic Performance of T-1 and T-2 Mapping to Detect Intramyocardial Hemorrhage in Reperfused ST-segment Elevation Myocardial Infarction Patients
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/jmri.25638
Publisher version: http://doi.org/10.1002/jmri.25638
Language: English
Additional information: © 2017 The Authors Journal of Magnetic Resonance Imaging published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: Science & Technology, Life Sciences & Biomedicine, Radiology, Nuclear Medicine & Medical Imaging, CARDIAC MAGNETIC-RESONANCE, PRE-CONTRAST T1, MICROVASCULAR OBSTRUCTION, PROGNOSTIC VALUE, STEMI PATIENTS, T2, RISK, EDEMA, AREA, CMR, ST-segment elevation myocardial infarction; T1 mapping; T2 mapping; math formula mapping; intramyocardial hemorrhage; microvascular obstruction
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Pre-clinical and Fundamental Science
URI: https://discovery.ucl.ac.uk/id/eprint/1542122
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