Wolfgang Wust MD, Presenter: Nothing to Disclose

Matthias Stefan May, Abstract Co-Author: Speakers Bureau, Siemens AG

Michael Marcus Lell MD, Abstract Co-Author: Research Grant, Siemens AG Speakers Bureau, Siemens AG Research Grant, Bayer AG Speakers Bureau, Bayer AG Research Consultant, Bracco Group

Michael Uder MD, Abstract Co-Author: Speakers Bureau, Bracco Group Speakers Bureau, Siemens AG Research Grant, Siemens AG

Axel Schmid MD, Abstract Co-Author: Nothing to Disclose

In cardiac MRI (cMRI) injection of contrast medium may be performed prior to the acquisition of cine steady-state free precession (SSFP) imaging to speed up the protocol and avoid delay before late Gadolinium enhancement (LGE) imaging. Aim of this study was to evaluate whether a condensed clinical protocol with contrast cine SSFP imaging is able to detect early microvascular obstruction (MO) and determine the infarct size compared to the findings of LGE inversion recovery sequences.  

The study complies with the Declaration of Helsinki and was performed following approval by the ethic committee of the University of Erlangen-Nuremberg. Written informed consent was obtained from every patient. 68 consecutive patients (14 females/54 males) with acute ST-elevation myocardial infarction (STEMI) treated by percutaneous coronary revascularization were included in this study. CMRI was performed 6.6±2 days after symptom onset and MO and infarct size in early contrast SSFP cine imaging were compared to LGE imaging.

MO was detected in 47/68 (69%) patients on cine SSFP and in 41/68 (60%) patients on LGE imaging. In 6 patients MO was found on cine SSFP imaging but was not detectable on LGE imaging. Infarct size on cine SSFP showed a strong agreement to LGE imaging (intraclass correlation coefficient [ICC] of 0.96 for enddiastolic, p<0.001 and 0.96 for endsystolic, p<0.001 respectively). Significant interobserver agreement was found measuring enddiastolic and endsystolic infarct size on cine SSFP imaging (p<0.01).

In patients after STEMI infarct size and presence of MO can be detected with contrast cine SSFP imaging. This could be an option in patients who are limited in their ability to comply with the demands of a cMRI protocol.

MO size is slightly overestimated on contrast enhanced cine SSFP imaging in particular in the case of larger MO areas, contrast enhanced cine SSFP imaging was able to detect all cases with MO on LGE imaging and could therefore indeed serve as a back-up if LGE imaging should not be evaluable.

Wust, W, May, M, Lell, M, Uder, M, Schmid, A, Determining Microvascular Obstruction and Infarct size with Steady-state Free Precession Imaging Cardiac MRI.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014192.html