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European Radiology
Published in: European Radiology 2/2018

Open Access 01-02-2018 | Cardiac

The influence of microvascular injury on native T1 and T2* relaxation values after acute myocardial infarction: implications for non-contrast-enhanced infarct assessment

Authors: Lourens F. H. J. Robbers, Robin Nijveldt, Aernout M. Beek, Paul F. A. Teunissen, Maurits R. Hollander, P. Stefan Biesbroek, Henk Everaars, Peter M. van de Ven, Mark B. M. Hofman, Niels van Royen, Albert C. van Rossum

Published in: European Radiology | Issue 2/2018

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Abstract

Objectives

Native T1 mapping and late gadolinium enhancement (LGE) imaging offer detailed characterisation of the myocardium after acute myocardial infarction (AMI). We evaluated the effects of microvascular injury (MVI) and intramyocardial haemorrhage on local T1 and T2* values in patients with a reperfused AMI.

Methods

Forty-three patients after reperfused AMI underwent cardiovascular magnetic resonance imaging (CMR) at 4 [3-5] days, including native MOLLI T1 and T2* mapping, STIR, cine imaging and LGE. T1 and T2* values were determined in LGE-defined regions of interest: the MI core incorporating MVI when present, the core-adjacent MI border zone (without any areas of MVI), and remote myocardium.

Results

Average T1 in the MI core was higher than in the MI border zone and remote myocardium. However, in the 20 (47%) patients with MVI, MI core T1 was lower than in patients without MVI (MVI 1048±78ms, no MVI 1111±89ms, p=0.02). MI core T2* was significantly lower in patients with MVI than in those without (MVI 20 [18-23]ms, no MVI 31 [26-39]ms, p<0.001).

Conclusion

The presence of MVI profoundly affects MOLLI-measured native T1 values. T2* mapping suggested that this may be the result of intramyocardial haemorrhage. These findings have important implications for the interpretation of native T1 values shortly after AMI.

Key points

• Microvascular injury after acute myocardial infarction affects local T1 and T2* values.
• Infarct zone T1 values are lower if microvascular injury is present.
• T2* mapping suggests that low infarct T1 values are likely haemorrhage.
• T1 and T2* values are complimentary for correctly assessing post-infarct myocardium.
Appendix
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Metadata
Title
The influence of microvascular injury on native T1 and T2* relaxation values after acute myocardial infarction: implications for non-contrast-enhanced infarct assessment
Authors
Lourens F. H. J. Robbers
Robin Nijveldt
Aernout M. Beek
Paul F. A. Teunissen
Maurits R. Hollander
P. Stefan Biesbroek
Henk Everaars
Peter M. van de Ven
Mark B. M. Hofman
Niels van Royen
Albert C. van Rossum
Publication date
01-02-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5010-x

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