Image quality and myocardial scar size determined with magnetic resonance imaging in patients with permanent atrial fibrillation : A comparison of two imaging protocols

• Background: Magnetic resonance imaging (MRI) of the heart generally requires breath holding and a regular rhythm. Single shot 2D steady-state free precession (SS_SSFP) is a fast sequence insensitive to arrhythmia as well as breath holding. Our purpose was to determine image quality, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios and infarct size with a fast single shot and a standard segmented MRI sequence in patients with permanent atrial fibrillation and chronic myocardial infarction.Methods: Twenty patients with chronic myocardial infarction and ongoing atrial fibrillation were examined with inversion recovery SS_SSFP and segmented inversion recovery 2D fast gradient echo (IR_FGRE). Image quality was assessed in four categories: delineation of infarcted and non-infarcted myocardium, occurrence of artefacts and overall image quality. SNR and CNR were calculated. Myocardial volume (ml) and infarct size, expressed as volume (ml) and extent (%), were calculated, and the methodological error was assessed.Results: SS_SSFP had significantly better quality scores in all categories (P = 0·037, P = 0·014, P = 0·021, P = 0·03). SNRinfarct and SNRblood were significantly better for IR_FGRE than for SS_SSFP (P = 0·048, P = 0·018). No significant difference was found in SNRmyocardium and CNR. The myocardial volume was significantly larger with SS_SSFP (170·7 versus 159·2 ml, P<0·001), but no significant difference was found in infarct volume and infarct extent.Conclusion: SS_SSFP displayed significantly better image quality than IR_FGRE. The infarct size and the error in its determination were equal for both sequences, and the examination time was shorter with SS_SSFP.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)

Nyckelord

Atrial fibrillation

Magnetic resonance imaging

Myocardial infarction

Segmented inversion recovery 2D fast gradient echo

Single shot inversion recovery 2D steady-state free precession

anticoagulant agent

antihypertensive agent

beta adrenergic receptor blocking agent

hydroxymethylglutaryl coenzyme A reductase inhibitor

oral antidiabetic agent

adult

aged

article

artifact

chronic disease

clinical article

clinical protocol

contrast enhancement

controlled study

disease severity

female

heart atrium fibrillation

heart infarction size

human

image display

image quality

intermethod comparison

male

nuclear magnetic resonance imaging

priority journal

signal noise ratio

steady state

Aged

80 and over

Artifacts

Cicatrix

Electrocardiography

Humans

Middle Aged

Myocardium

Reproducibility of Results

Systole

Ventricular Function

Left

Radiology

Cardiology

MEDICINE

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