Vergleich der ödemsensitiven HASTE-TIRM-Sequenz mit der späten Kontrastmittelanreicherung bei akutem Myokardinfarkt

Goal: Comparison between a fluid-sensitive (HASTE-TIRM)-sequence and delayed contrast-enhancement in patients with acute myocardial infarct (AMI) in MRI. Material and Methods: 32 patients with AMI were imaged 7 ± 4 days after the time of infarction with a 1.5 T unit using a T 2 HASTE-TIRM and a contrast-enhanced (CE) T 1 turbo FLASH sequence. A threshold method (>2 SD in comparison with normal myocardium) was used to quantify the hyperintense zones in both sequences. The transmurality of the hyperintense regions was measured on a segmental basis. Results: The hyperintense areas were larger on the HASTE-TIRM sequence with 29.6 ± 13.2% of the left ventricular (LV) area as compared to the CE-MRI with 19.2 ± 10% of the LV area (p < 0.0001). The measured transmurality was higher with the HASTE-TIRM sequence than with the CE-MRI (p < 0.0001). While the correlation between CE-MRI and peak creatine kinase (CK max) was good (r = 0.59, p < 0.001), no correlation was found between the HASTE-TIRM sequence and CK max (r=0.29, p=ns). Conclusions: The peri-infarct edema can be depicted with a HASTE-TIRM sequence in addition to the non-viable infarct zone. The HASTE-TIRM sequence shows a higher transmurality of the hyperintense regions than the CE-MRI. The additional area depicted by the HASTE-TIRM sequence could represent functionally impaired but viable myocardium).