Contrast-enhanced magnetic resonance imaging assessment of scar size in patients with chronic myocardial infarction

Oronzo Catalano, Serena Antonaci, Guido Moro, Giorgio Cannizzaro, Renato Mingrone, Cristina Opasich, Mauro Frascaroli, Felice Rognone, Maurizia Baldi, Roberto Tramarin

Research output: Contribution to journalArticle

Abstract

Background. In the assessment of myocardial infarction (MI) mass, contrast-enhanced magnetic resonance imaging (CE-MRI) is comparable to single-photon emission computed tomography (SPECT). The aim of the present study was to determine whether the MI area, as assessed at CE-MRI and SPECT, is comparable to mass evaluation. We also compared CE-MRI and SPECT estimates of the MI area with functional evaluations made at echocardiography and kinetic MRI (cine-MRI). Methods. We used a 1.0 Tesla MRI scanner and an inversion-recovery turboFLASH sequence, a tomographic gamma-camera and second-harmonic ultrasound systems. Two blinded operators assessed the extent of scarring, expressed as a percentage of the whole left ventricle (LV), using a 16-segment model. We studied 55 consecutive patients with a clinically stable healed MI (50 Q wave, 5 non-Q wave). Results. The scar mass was 19 ± 23% of the LV at CE-MRI and 21 ± 25% at SPECT; the scar area was 29 ± 23% of the LV at CE-MRI, 41 ± 28% at SPECT, 29 ± 31% at cine-MRI, and 32 ± 29% at echocardiography. The Bland-Altman bias between CE-MRI and SPECT mass estimations was -2% of the LV with a ± 23% limit of agreement (LOA), while the bias between the area assessments was -12% with a ± 42% LOA. Bias between CE-MRI and functional evaluation by cine-MRI and echocardiography was 0% with a ± 39% LOA and -3% with a ± 36% LOA respectively. Comparing SPECT with cine-MRI and echocardiography the bias was 12% with a ± 52% LOA and 9% with a ± 56% LOA respectively. Conclusions. CE-MRI has proved to be comparable to SPECT in the assessment of the healed MI mass. Conversely, a high systematic error (high bias and LOA) renders CE-MRI and SPECT assessments of the MI area incomparable. Similarly (high bias and/or LOA) CE-MRI and SPECT estimations of the MI area cannot be compared with functional evaluation by echocardiography or cine-MRI.

Original languageEnglish
Pages (from-to)133-137
Number of pages5
JournalItalian Heart Journal
Volume6
Issue number2
Publication statusPublished - Feb 2005

Keywords

  • Echocardiography
  • Magnetic resonance imaging
  • Myocardial infarction
  • Singlephoton emission computed tomography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Catalano, O., Antonaci, S., Moro, G., Cannizzaro, G., Mingrone, R., Opasich, C., Frascaroli, M., Rognone, F., Baldi, M., & Tramarin, R. (2005). Contrast-enhanced magnetic resonance imaging assessment of scar size in patients with chronic myocardial infarction. Italian Heart Journal, 6(2), 133-137.