Cardiac diffusion-weighted MR imaging in recent, subacute, and chronic myocardial infarction: A pilot study

Jean Pierre Laissy, Virginia Gaxotte, Elisabeth Ironde-Laissy, Isabelle Klein, Aurélie Ribet, Ahmed Bendriss, Sylvie Chillon, Elisabeth Schouman-Claeys, P. Gabriel Steg, Jean Michel Serfaty

Research output: Contribution to journalArticle

Abstract

Purpose: To investigate the clinical feasibility of diffusion-weighted imaging (DWI) to detect recent myocardial infarction (MI) and to differentiate it from subacute and chronic MI, with late-gadolinium enhancement (LGE) sequence as reference. Furthermore, to measure variation of the myocardial apparent diffusion coefficient (ADC) according to the age of MI. Materials and Methods: Seventy-four MI patients were separated in 3 groups. Group A included 34 recent (<8 days) MI patients; group B, 22 subacute (9-90 days) MI patients; group C, 18 chronic (> 90 days) MI patients; a fourth group (group D) included 24 controls. DWI and LGE images were acquired on a 1.5T system. DWI and LGE matched images were assessed visually by two blinded observers for hyperintense areas in corresponding segments. Results: Qualitative assessment of DWI compared with LGE images yielded a sensitivity of 97% and a specificity of 61%/14% to differentiate recent from chronic/subacute MI, respectively. The absolute ADCs (recent 0.00632 ± 0.00037 mm2/s, subacute 0.00639 ± 0.00035 mm2/s, chronic 0.00743 ± 0.00056 mm2/s, remote or normal 0.00895 ± 0.00019 mm2/s) and relative ADCs were significantly different between groups (P <0.001) except between recent and subacute MIs. Conclusion: DWI is a sensitive technique to diagnose recent MI. DWI MR sequences could help differentiate recent from chronic MI. From these preliminary results, one should expect DWI to be used in the triage of emergency patients with atypical chest pain, to clarify if an MI is present or not in just a few minutes.

Original languageEnglish (US)
Pages (from-to)1377-1387
Number of pages11
JournalJournal of Magnetic Resonance Imaging
Volume38
Issue number6
DOIs
StatePublished - Dec 2013
Externally publishedYes

Keywords

  • diffusion-weighted imaging
  • late-gadolinium enhancement
  • magnetic resonance imaging
  • myocardial infarction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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