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Native T1 Mapping by 3-T CMR Imaging for Characterization of Chronic Myocardial Infarctions

 Avinash Kali  ;  Eui-Young Choi  ;  Behzad Sharif  ;  Young Jin Kim  ;  Xiaoming Bi  ;  Bruce Spottiswoode  ;  Ivan Cokic  ;  Hsin-Jung Yang  ;  Mourad Tighiouart  ;  Antonio Hernandez Conte  ;  Debiao Li  ;  Daniel S. Berman  ;  Byoung Wook Choi  ;  Hyuk-Jae Chang  ;  Rohan Dharmakumar 
 JACC-CARDIOVASCULAR IMAGING, Vol.8(9) : 1019-1030, 2015 
Journal Title
Issue Date
chronic myocardial infarction ; native T1 mapping ; viability imaging
OBJECTIVES: The purpose of this study was to investigate whether native T1 maps at 3-T can reliably characterize chronic myocardial infarctions (MIs) in patients with prior ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI). BACKGROUND: Late gadolinium enhancement (LGE) cardiac magnetic resonance is the gold standard for characterizing chronic MIs, but it is contraindicated in patients with end-stage chronic kidney disease. METHODS: Native T1 and LGE images were acquired at 3-T in patients with prior STEMI (n = 13) and NSTEMI (n = 12) at a median of 13.6 years post-MI. Infarct location, size, and transmurality were measured using mean ± 5 SDs thresholding criterion from LGE images and T1 maps and compared against one another. Independent reviewers assessed visual conspicuity of MIs on LGE images and T1 maps. RESULTS: Native T1 maps and LGE images were not different for measuring infarct size (STEMI: p = 0.46; NSTEMI: p = 0.27) and transmurality (STEMI: p = 0.13; NSTEMI: p = 0.21) using thresholding criterion. Using thresholding criterion, good agreement was observed between LGE images and T1 maps for measuring infarct size (STEMI: bias = 0.6 ± 3.1%; R(2) = 0.93; NSTEMI: bias = -0.4 ± 4.4%; R(2) = 0.85) and transmurality (STEMI: bias = 2.0 ± 4.2%; R(2) = 0.89; NSTEMI: bias = -2.7 ± 7.9%; R(2) = 0.68). Sensitivity and specificity of T1 maps for detecting chronic MIs based on thresholding criterion were 89% and 98%, respectively (STEMI), and 87% and 95%, respectively (NSTEMI). Relative to LGE images, the mean visual conspicuity score for detecting chronic MIs was significantly lower for T1 maps (p < 0.001 for both cases). Median infarct-to-remote myocardium contrast-to-noise ratio was 2.5-fold higher for LGE images relative to T1 maps (p < 0.001). Sensitivity and specificity of T1 maps for visual detection were 60% and 86%, respectively (STEMI), and 64% and 91% (NSTEMI), respectively. CONCLUSIONS: Chronic MIs in STEMI and NSTEMI patients can be reliably characterized using threshold-based detection on native T1 maps at 3-T. Visual detection of chronic MIs on native T1 maps in both patient populations has high specificity, but modest sensitivity.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Choi, Eui Young(최의영) ORCID logo https://orcid.org/0000-0003-3732-0190
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