Detecting acute reperfusion myocardial hemorrhage with CMR: a translational study
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Detecting acute reperfusion myocardial hemorrhage with CMR: a translational study Avinash Kali1,2*, Andreas Kumar3, Richard L Tang2, Rohan Dharmakumar2 From 15th Annual SCMR Scientific Sessions Orlando, FL, USA. 2-5 February 2012 Background Hemorrhage is a frequent hallmark of large acute reperfused myocardial infarctions (rMI). Recently, there has been a growing interest in CMR for noninvasive detection of hemorrhage in rMI. While T2*- and T2-weighted CMR have been used for this purpose, there is a lack of consensus on which of these methods is the most appropriate and reliable. We investigated the relative abilities of T2 and T2* CMR for detecting hemorrhage in rMI in a canine model and patients. Methods Canines (n=14), subjected to ischemia-reperfusion (I/R) injury (3 hrs of LAD occlusion followed by reperfusion), underwent CMR (1.5T) studies on day 5 post reperfusion. T2*-weighted (multi GRE; TE=3.4-18.4ms (6 echoes)), T2-weighted (T2-prep SSFP; prep times=0, 24 and 55 ms), T2-STIR (TE=64 ms) and Late Enhancement (LE) images covering the LV were acquired. Imaging resolution of all the scans was 1.3x1.3x8 mm3. Patients (n=14) underwent CMR (1.5T) on day 3 post angioplasty for STEMI after providing informed consent. T2*-weighted (TE=2.6-13.8ms (6 echoes)), T2-STIR (TE=61ms) and LE images covering the LV were acquired. Imaging resolution of all the scans was 1.4x1.4x10 mm3. T2* and T2 maps were constructed by fitting the multi-echo data to monoexponential decay. A thresholdbased signal analysis was used to identify hemorrhagic (Hemo+) and non-hemorrhagic (Hemo-) infarcts. T2STIR signal intensity (STIR-SI), T2* and T2 values, measured from Remote, Hemo- and Hemo+ regions, were compared. Statistical significance was set at p
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