Vittorio Semeraro MD, Abstract Co-Author: Nothing to Disclose

Ferdinando Ferrara MD, Abstract Co-Author: Nothing to Disclose

Agostino Meduri MD, Abstract Co-Author: Nothing to Disclose

Riccardo Marano MD, Abstract Co-Author: Nothing to Disclose

Luigi Natale MD, Presenter: Nothing to Disclose

Lorenzo Bonomo MD, Abstract Co-Author: Nothing to Disclose

Microvascolar obstruction and hemorrage represents negative prognostic factors in reperfused acute myocardial infarction. We evaluated T2* measurement to assess their presence.

47 consecutive pts with first acute myocardial infarction treated by primary PCI were studied within first week, employing a conventional cardiac MRI protocol (T2 triple IR-FSE, cine-SSFP, rest FGRET and 2D IR-FGRE). Before contrast injection an ECG gated T2* multiecho FGRE sequence at the level of the infarcted area was acquired. Echo times ranged from 1.8 ms to 20 ms. T2* was calculated using the Reportcard 4.0 software (GE Medical Systems).

A cut-off value of 20 ms was used, based on published data and a normal population evaluated as reference group in a multicenter study on thalassemia. T2* values werelower (ranging betwen 12 and 18 ms) in 14 pts. In these pts, T2 triple IR-FSE images were postive for hemorrage in 9, while first pass and/or IR-FGRE were positive for microvascular obstruction in 12. All pts showing hemorrage at T2 triple IR-FSE presented also microvascular obstruction at first pass and/or IR-FGRE.

T2* multiecho imaging is feasible for T2* measurements in pts with reperfused acute myocardial infarction. Furthermore hemorrage and severe microvascular obstruction represent the same type of complication as all pts with T2 triple IR FSE positive for hemorrage showed microvascular obstrution , and T2* imaging was positive in the other pts with microvascular obstruction. The discrepancy between T2* and T2 triple FSE is due to the superior sensitivity of T2* compared to T2 imaging.

T2* measurement is more sensitive and can be used in daily practice to assess reperfusion injury; hemorrage and microvascular obstruction represent the same event and the same poor prognostic factor.

Semeraro, V, Ferrara, F, Meduri, A, Marano, R, Natale, L, Bonomo, L, T2* Measurement in Reperfused Acute Myocardial Infarction: Hemorrhage and Microvascular Obstruction.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11012862.html