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Value of T2-weighted, first-pass and delayed enhancement, and cine CMR to differentiate between acute and chronic myocardial infarction

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Abstract

The aim of this study was to analyze the diagnostic accuracy of edema on T2-weighted (T2w) cardiac magnetic resonance imaging (CMR), presence of microvascular obstruction (MO) on first-pass enhancement (FPE) or on delayed enhancement (DE) CMR, and wall thinning on cine CMR to differentiate between acute (AMI) and chronic myocardial infarction (CMI) in patients with infarction on DE-CMR. Fifty patients were imaged 5 ± 3 days (baseline) and 8 ± 3 months (follow-up) after AMI at 1.5 T. Imaging findings were graded as present or absent in a blinded consensus reading. Edema was present at baseline in 48 (96%) patients and absent at follow-up in 49 (98%) patients. At baseline, MO was present in 29 (58%) patients on FPE-CMR and in 24 (48%) patients on DE-CMR (P  = ns). At follow-up, persisting hypoenhancement was observed in ten (20%) patients on FPE-CMR, whereas two (4%) patients showed persisting hypoenhancement on DE-CMR (P<0.05). Wall thinning was present in 4 (8%) patients at baseline and in 20 (40%) patients at follow-up. Edema had high sensitivity (96%), specificity (98%), and accuracy (97%) to differentiate between AMI and CMI. Accuracy of all other imaging findings was lower compared to that of edema (P<0.001). In the presence of infarction on DE-CMR, T2w-CMR reliably differentiates between AMI and CMI.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

    Alexander Stork, Paul M. Bansmann, Michael Kaul, Joern Kemper & Gerhard Adam

  2. Department of Cardiology/Angiology, Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Kai Muellerleile & Gunnar K. Lund

  3. Siemens Medical Solutions, Lindenplatzz, 20099, Hamburg, Germany

    Joachim Graessner

Authors
  1. Alexander Stork
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  2. Kai Muellerleile
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  3. Paul M. Bansmann
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  4. Joachim Graessner
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  5. Michael Kaul
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  6. Joern Kemper
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  7. Gerhard Adam
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  8. Gunnar K. Lund
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Corresponding author

Correspondence to Alexander Stork.

Additional information

This study was funded in part by the Pinguin-Stiftung, Düsseldorf, Germany and by the Schering Company, Berlin, Germany.

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Stork, A., Muellerleile, K., Bansmann, P.M. et al. Value of T2-weighted, first-pass and delayed enhancement, and cine CMR to differentiate between acute and chronic myocardial infarction. Eur Radiol 17, 610–617 (2007). https://doi.org/10.1007/s00330-006-0460-6

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  • DOI: https://doi.org/10.1007/s00330-006-0460-6

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