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Title: Acute myocardial infarction: Susceptibility-weighted cardiac MRI for the detection of reperfusion haemorrhage at 1.5 T
Authors: Durighel G.
Tokarczuk P.F.
Karsa A.
Gordon F.
Cook S.A. 
O'Regan D.P.
Issue Date: 2016
Publisher: W.B. Saunders Ltd
Citation: Durighel G., Tokarczuk P.F., Karsa A., Gordon F., Cook S.A., O'Regan D.P. (2016). Acute myocardial infarction: Susceptibility-weighted cardiac MRI for the detection of reperfusion haemorrhage at 1.5 T. Clinical Radiology 71 (3) : e150-e156. ScholarBank@NUS Repository.
Abstract: Aim To assess whether susceptibility-weighted imaging (SWI) provides better image contrast for the detection of haemorrhagic ischaemia-reperfusion injury in the heart. Materials and methods Thirty patients (all men; mean age 53 years) underwent cardiac magnetic resonance imaging (MRI) within 7 days of primary percutaneous intervention for acute ST elevation myocardial infarction (STEMI). Multiple gradient-echo T2?sequences with magnitude and phase reconstructions were acquired. A high-pass filtered phase map was used to create a mask for the SWI reconstructions. The difference in image contrast was assessed in those patients with microvascular obstruction. A mixed effects regression model was used to test the effect of echo time and reconstruction method on phase and contrast-to-noise ratio (CNR). Medians and interquartile ranges (IQR) are reported. Results T2?in haemorrhagic infarcts was shorter than in non-haemorrhagic infarcts (33.5 ms [24.9-43] versus 49.9 ms [44.6-67.6]; p=0.0007). The effect of echo time on phase was significant (p<0.0001), as was the effect of haemorrhage on phase (p=0.0016). SWI reconstruction had a significant effect on the CNR at all echo times (echoes 1-5, p<0.0001; echo 6, p=0.01; echo 7, p=0.02). The median echo number at which haemorrhage was first visible was less for SWI compared to source images (echo 2 versus echo 5, p=0.0002). Conclusion Cardiac SWI improves the contrast between myocardial haemorrhage and the surrounding tissue following STEMI and has potential as a new tool for identifying patients with ischaemia-reperfusion injury. � 2015 The Royal College of Radiologists.
Source Title: Clinical Radiology
ISSN: 99260
DOI: 10.1016/j.crad.2015.12.008
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