BACKGROUND:Intramyocardial hemorrhage (IMH) identified by cardiovascular magnetic resonance (CMR) is an established prognostic marker following acute myocardial infarction (AMI). Detection of IMH by T2-weighted or T2 star CMR can be limited by long breath hold times and sensitivity to artefacts, especially at 3T. We compared the image quality and diagnostic ability of susceptibility-weighted magnetic resonance imaging (SW MRI) with T2-weighted and T2 star CMR to detect IMH at 3T.METHODS:Forty-nine patients (42 males; mean age 58years, range 35-76) underwent 3T cardiovascular magnetic resonance (CMR) 2days following re-perfused AMI. T2-weighted, T2 star and SW MRI images were obtained. Signal and contrast measurements were compared between the three methods and diagnostic accuracy of SW MRI was assessed against T2w images by 2 independent, blinded observers. Image quality was rated on a 4-point scale from 1 (unusable) to 4 (excellent).RESULTS:Of 49 patients, IMH was detected in 20 (41%) by SW MRI, 21 (43%) by T2-weighted and 17 (34%) by T2 star imaging (p=ns). Compared to T2-weighted imaging, SW MRI had sensitivity of 93% and specificity of 86%. SW MRI had similar inter-observer reliability to T2-weighted imaging (kappa=0.90 and kappa=0.88 respectively); both had higher reliability than T2 star (kappa=0.53). Breath hold times were shorter for SW MRI (4seconds vs. 16seconds) with improved image quality rating (3.8+/-0.4, 3.3+/-1.0, 2.8+/-1.1 respectively; p<0.01).CONCLUSIONS:SW MRI is an accurate and reproducible way to detect IMH at 3T. The technique offers considerably shorter breath hold times than T2-weighted and T2 star imaging, and higher image quality scores.
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)