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DOI:10.2214/AJR.08.1580
AJR 2009; 192:W277-W281
© American Roentgen Ray Society

Original Research

Free-Breathing MRI for the Assessment of Myocardial Infarction: Clinical Validation

Harrie C. M. van den Bosch1, Jos J. M. Westenberg2, Johannes C. Post3, Glenn Yo1, Jan Verwoerd4, Lucia J. M. Kroft2 and Albert de Roos2

1 Department of Radiology, Catharina Hospital, Michelangelolaan 2, 5623EJ Eindhoven, The Netherlands.
2 Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.
3 Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.
4 Philips Healthcare, Eindhoven, The Netherlands.

OBJECTIVE. The objective of our study was to validate free-breathing 2D inversion recovery delayed-enhancement MRI for the assessment of myocardial infarction compared with a breath-hold 3D technique.

SUBJECTS AND METHODS. Institutional review board approval and written informed consent were obtained. Thirty-two patients (25 men, seven women; mean age, 68 years; age range, 39–84 years) underwent breath-hold gradient-echo 3D inversion-recovery delayed-enhancement MRI and free-breathing respiratory-triggered 2D inversion-recovery delayed-enhancement MRI of the heart (scanning time, 50–80 seconds). Infarct size was quantitatively analyzed as a percentage of the left ventricle. The location and transmural extent of myocardial infarction were assessed by visual scoring. Intraclass correlation and Bland-Altman analysis were used to evaluate the agreement between the techniques for infarct quantification. Kappa statistics were used to analyze the visual score.

RESULTS. Excellent agreement between the two techniques was observed for infarct quantification (intraclass correlation = 0.99 [p < 0.01]; mean difference ± SD = 0.32% ± 2.4%). The agreement in assessing transmural extent of infarction was good to excellent between the free-breathing technique and the 3D breath-hold technique (kappa varied between 0.70 and 0.96 for all segments). No regions of infarction were missed using the free-breathing approach.

CONCLUSION. The free-breathing 2D delayed-enhancement MRI sequence is a fast and reliable tool for detecting myocardial infarction.

Keywords: heart • ischemia • MRI • myocardial infarction


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