Delayed Enhancement Imaging: Standardized Segmental Assessment of Myocardial Viability in Patients with ST-Elevation Myocardial Infarction

Objective: To prospectively compare a selective short axis slice positioning method (selective 3-of-5) used in combination with a single long-axis slice, to the conventional short axis multi-slice technique in the assessment of myocardial viability.

Materials and methods: Thirty-one patients with recent or chronic ST segment elevation myocardial infarct (STEMI) were recruited to undergo delayed enhancement (DE) cardiac magnetic resonance imaging (CMR). All patients underwent both methods of DE imaging, with subsequent review of both sets of data by two experienced observers. Sensitivity and specificity, as well as intra and interobserver reproducibility for both techniques were assessed.

Results: There was good agreement between the selective 3-of-5 and the conventional multi-slice method for the assessment of viability, with no significant difference in results for sensitivity or reproducibility between the techniques.

Conclusion: In patients with STEMI, a selective 3-of-5 short axis slice acquisition used in combination with a single vertical long-axis slice can be utilised to produce a standard American Heart Association (AHA) 17-segment model for the assessment of myocardial viability.