Patrick Krumm, Abstract Co-Author: Nothing to Disclose

Petros Martirosian PhD, Abstract Co-Author: Nothing to Disclose

Tanja Zitzelsberger MD, Abstract Co-Author: Nothing to Disclose

Dominik Rath MD, Abstract Co-Author: Nothing to Disclose

Bernhard Klumpp MD, Abstract Co-Author: Nothing to Disclose

Stefanie Mangold MD, Abstract Co-Author: Nothing to Disclose

Tobias Geisler MD, Abstract Co-Author: Nothing to Disclose

Konstantin Nikolaou MD, Abstract Co-Author: Speakers Bureau, Siemens AG Speakers Bureau, Bracco Group Speakers Bureau, Bayer AG

Fritz Schick MD, PhD, Abstract Co-Author: Nothing to Disclose

Ulrich Kramer MD, Abstract Co-Author: Nothing to Disclose

Fabian Bamberg MD, MPH, Presenter: Speakers Bureau, Bayer AG Speakers Bureau, Siemens AG Research Grant, Bayer AG Research Grant, Siemens AG

T2 mapping is an approach to quantify and objectify edema imaging in cardiac MRI. To date T2 mapping is based on steady-state free precession (SSFP) sequences. Aim of this study was to establish a new multi echo turbospinecho (METSE) sequence for T2 mapping and compare it to hitherto established methods.

24 patients (age 60.8±13 years, 4 women) with ST elevation myocardial infarction were prospectively included. Cardiac MRI at 1.5 T was performed 2.5±1.2 days after interventional revascularization. Edema was evaluated with METSE mapping, SSFP T2 mapping; and a single echo TSE (SETSE). T2-decay time (T2DT) was evaluated in three representative short axe slices in a 16 segment model with a linear fit in MATLAB R2001b (Mathworks). Late gadolinium enhancement (LGE) and edema in the SETSE were evaluated qualitatively. A control group of 5 probands was examined for edema imaging. T2DT was compared in 4 segment groups: 1) with LGE, 2) penumbra, 3) remote from LGE, 4) controls. Artifacts and unevaluable segments were evaluated.

133 segments were LGE-positive. In METSE T2DT was 1) with LE 81±21ms; 2) penumbra 65±15ms , 3) remote 60±12ms, 4) controls 57±7ms. In SSFP T2DT was 1) with LE 71±12ms, 2) penumbra 62±12ms, 3) remote 61±11ms, 4) controls 57±5ms. Both sequences showed cut-off values for positive findings around 65ms. Out of 384 segments, the following segments were unevaluable: in METSE 21 (5 due to suszeptibility, 16 due to breathing artifacts); in SSFP 62 (40 due to ECG trigger artifacts, 22 due to breathing artifacts); in SETSE 40 (24 due to suszeptibility and 16 due to breathing artifacts). SETSE showed false negative results in 44% of the segments and could show penumbra edema in 21 % of the cases.

Both the established SSFP and the new METSE sequence showed myocardial edema with comparable results. METSE showed only a third of unevaluable segments compared to SSFP; but in 67% of the cases artifacts did not appear in both sequences. Penumbra and remote myocardium showed higher T2DT values as controls as a sign for generalized myocardial edema in severe ST-positive myocardial infarction. This effect cannot be qualitatively evaluated in SETSE.

METSE T2 mapping is an alternative besides established SSFP T2 mapping that can be considered in case of unevaluable SSFP images - which is relevant in morbid patients with arrhythmia or dyspnea.

Krumm, P, Martirosian, P, Zitzelsberger, T, Rath, D, Klumpp, B, Mangold, S, Geisler, T, Nikolaou, K, Schick, F, Kramer, U, Bamberg, F, T2 Mapping in Cardiac MRI based on Multi Echo Turbo Spin Echo: A New Mapping Method.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045537.html