Performance of two Methods for Cardiac MRI Edema Mapping: Dual-Contrast Fast Spin-Echo and T2 Prepared Balanced Steady State Free Precession.

Purpose:  To compare true positive and false negative results of myocardial edema mapping in two methods. Myocardial edema may be difficult to detect on cardiac MRI.

Materials And Methods:  76 patients (age 59 ± 11 years, 15 female) with acute myocardial infarction (MI) and 10 healthy volunteers were prospectively included in this single-center study. 1.5 T cardiac MRI was performed in patients 2.5 days after revascularization (median) for edema mapping: Steady State Free Precession (SSFP) mapping sequence with T-preparation pulses (Tprep); and dual-contrast Fast Spin-Echo (dcFSE) signal decay edema mapping. Late gadolinium enhancement (LGE) was used as the reference for expected edema in acute MI.

Results:  311 myocardial segments in patients were acutely infarcted with mean T 73 ms for Tprep SSFP vs. 87 ms for dcFSE edema mapping. In healthy volunteers the mean T was 56 ms for Tprep SSFP vs. 50 ms for dcFSE edema mapping. Receiver operating characteristic (ROC) curve for Tprep SSFP show area under the curve (AUC) 0.962, p < 0.0001, Youden index J 0.8266, associated criterion > 60 ms, sensitivity 94 %, specificity 89 %. dcFSE ROC AUC 0.979, p < 0.0001, J 0.9219, associated criterion > 64 ms, sensitivity 93 %, specificity 99 %.

Conclusion:  Both edema mapping methods indicate high-grade edema with high sensitivity. Nevertheless, edema in acute infarction may be focally underestimated in both mapping methods.

Key Points:   · Sensitivity for edema detection is high for both methods.. · Edema may be focally underestimated by T2prep SSFP edema mapping and dcFSE mapping..

Citation Format: · Krumm P, Martirosian P, Rath D et al. Performance of two Methods for Cardiac MRI Edema Mapping: Dual-Contrast Fast Spin-Echo and T2 Prepared Balanced Steady State Free Precession. Fortschr Röntgenstr 2020; 192: 669 - 677.