Myocardial area at risk and salvage measured by T2-weighted cardiovascular magnetic resonance: reproducibility and comparison of two T2-weighted protocols

TY - JOUR

T1 - Myocardial area at risk and salvage measured by T2-weighted cardiovascular magnetic resonance: reproducibility and comparison of two T2-weighted protocols

AU - Lønborg, Jacob

AU - Vejlstrup, Niels

AU - Mathiasen, Anders B

AU - Thomsen, Carsten

AU - Jensen, Jan S

AU - Engstrøm, Thomas

PY - 2011

Y1 - 2011

N2 - Background: Late Gadolinium Enhancement (LGE) and T2-weighted cardiovascular magnetic resonance (CMR) provides a means to measure myocardial area at risk (AAR) and salvage. Several T2-weighted CMR sequences are in use, but there is no consensus in terms of which sequence to be the preferred. Therefore, the aim of the present study was to: (1) Assess the reproducibility and (2) compare the two most frequently used T2-weighted CMR protocols for measuring AAR and salvage. Methods. 91 patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention underwent a CMR scan 1-7 days after initial treatment. Two different T2-weighted protocols, varying in slice thickness and echo time (TE), were applied covering the entire left ventricle (LV) (protocol 1: TE 65 msec and slice thickness 15 mm; protocol 2: TE 100 msec and slice thickness of 8 mm). On a second scan performed 3 months later, infarct size was assessed with a standard LGE sequence. The two protocols were compared in terms of AAR and salvage index. Furthermore, intra- and interobserver reproducibility were assessed. Results: Protocol 1 measures a larger AAR and salvage index than protocol 2 with a mean difference in AAR of 1 8%LV (p < 0.01) and 6 12 g (p < 0.01) and salvage index of 0.04 0.12 (p < 0.01). Both protocols had a high intra- and interobserver reproducibility with acceptable limits of agreement (6-8%LV and 6-12 g in AAR and 0.06-0.08 in salvage index). Conclusions: We report acceptable reproducibility for AAR and salvage index measured by T2-weighted images. Thus CMR is a reliable tool for measuring AAR and salvage index. Protocol 2 (8 mm slice thickness and 100 msec TE) measures slightly smaller AAR than protocol 1 (15 mm slice thickness and 65 msec TE), but the present study does not allow for a clear recommendation of either of the protocols.

AB - Background: Late Gadolinium Enhancement (LGE) and T2-weighted cardiovascular magnetic resonance (CMR) provides a means to measure myocardial area at risk (AAR) and salvage. Several T2-weighted CMR sequences are in use, but there is no consensus in terms of which sequence to be the preferred. Therefore, the aim of the present study was to: (1) Assess the reproducibility and (2) compare the two most frequently used T2-weighted CMR protocols for measuring AAR and salvage. Methods. 91 patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention underwent a CMR scan 1-7 days after initial treatment. Two different T2-weighted protocols, varying in slice thickness and echo time (TE), were applied covering the entire left ventricle (LV) (protocol 1: TE 65 msec and slice thickness 15 mm; protocol 2: TE 100 msec and slice thickness of 8 mm). On a second scan performed 3 months later, infarct size was assessed with a standard LGE sequence. The two protocols were compared in terms of AAR and salvage index. Furthermore, intra- and interobserver reproducibility were assessed. Results: Protocol 1 measures a larger AAR and salvage index than protocol 2 with a mean difference in AAR of 1 8%LV (p < 0.01) and 6 12 g (p < 0.01) and salvage index of 0.04 0.12 (p < 0.01). Both protocols had a high intra- and interobserver reproducibility with acceptable limits of agreement (6-8%LV and 6-12 g in AAR and 0.06-0.08 in salvage index). Conclusions: We report acceptable reproducibility for AAR and salvage index measured by T2-weighted images. Thus CMR is a reliable tool for measuring AAR and salvage index. Protocol 2 (8 mm slice thickness and 100 msec TE) measures slightly smaller AAR than protocol 1 (15 mm slice thickness and 65 msec TE), but the present study does not allow for a clear recommendation of either of the protocols.

U2 - http://dx.doi.org/10.1186/1532-429X-13-50

DO - http://dx.doi.org/10.1186/1532-429X-13-50

M3 - Journal article

SN - 1097-6647

VL - 13

SP - 50

JO - Journal of Cardiovascular Magnetic Resonance

JF - Journal of Cardiovascular Magnetic Resonance

ER -