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Relationship of T2-Weighted MRI Myocardial Hyperintensity and the Ischemic Area-At-Risk.

dc.contributor.author Bhatti, L
dc.contributor.author Chen, E-L
dc.contributor.author Crowley, ALC
dc.contributor.author Jenista, ER
dc.contributor.author Jennings, RB
dc.contributor.author Jensen, CJ
dc.contributor.author Judd, RM
dc.contributor.author Kim, Han Woong
dc.contributor.author Kim, RJ
dc.contributor.author Klem, Igor
dc.contributor.author Parker, MA
dc.contributor.author Rehwald, WG
dc.contributor.author Spatz, DM
dc.contributor.author Van Assche, L
dc.contributor.author Wendell, David
dc.contributor.author Wince, WB
dc.coverage.spatial United States
dc.date.accessioned 2018-01-05T21:31:06Z
dc.date.available 2018-01-05T21:31:06Z
dc.date.issued 2015-07-17
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/25972514
dc.identifier CIRCRESAHA.117.305771
dc.identifier.uri https://hdl.handle.net/10161/15963
dc.description.abstract RATIONALE: After acute myocardial infarction (MI), delineating the area-at-risk (AAR) is crucial for measuring how much, if any, ischemic myocardium has been salvaged. T2-weighted MRI is promoted as an excellent method to delineate the AAR. However, the evidence supporting the validity of this method to measure the AAR is indirect, and it has never been validated with direct anatomic measurements. OBJECTIVE: To determine whether T2-weighted MRI delineates the AAR. METHODS AND RESULTS: Twenty-one canines and 24 patients with acute MI were studied. We compared bright-blood and black-blood T2-weighted MRI with images of the AAR and MI by histopathology in canines and with MI by in vivo delayed-enhancement MRI in canines and patients. Abnormal regions on MRI and pathology were compared by (a) quantitative measurement of the transmural-extent of the abnormality and (b) picture matching of contours. We found no relationship between the transmural-extent of T2-hyperintense regions and that of the AAR (bright-blood-T2: r=0.06, P=0.69; black-blood-T2: r=0.01, P=0.97). Instead, there was a strong correlation with that of infarction (bright-blood-T2: r=0.94, P<0.0001; black-blood-T2: r=0.95, P<0.0001). Additionally, contour analysis demonstrated a fingerprint match of T2-hyperintense regions with the intricate contour of infarcted regions by delayed-enhancement MRI. Similarly, in patients there was a close correspondence between contours of T2-hyperintense and infarcted regions, and the transmural-extent of these regions were highly correlated (bright-blood-T2: r=0.82, P<0.0001; black-blood-T2: r=0.83, P<0.0001). CONCLUSION: T2-weighted MRI does not depict the AAR. Accordingly, T2-weighted MRI should not be used to measure myocardial salvage, either to inform patient management decisions or to evaluate novel therapies for acute MI.
dc.language eng
dc.relation.ispartof Circ Res
dc.relation.isversionof 10.1161/CIRCRESAHA.117.305771
dc.subject MRI
dc.subject magnetic resonance
dc.subject myocardial infarction
dc.subject Adult
dc.subject Aged
dc.subject Animals
dc.subject Coronary Circulation
dc.subject Diagnosis, Differential
dc.subject Dogs
dc.subject Edema
dc.subject Endpoint Determination
dc.subject Female
dc.subject Fluorescent Dyes
dc.subject Heart
dc.subject Humans
dc.subject Magnetic Resonance Imaging
dc.subject Male
dc.subject Microspheres
dc.subject Middle Aged
dc.subject Myocardial Infarction
dc.subject Myocardium
dc.subject Organ Size
dc.subject Organometallic Compounds
dc.subject Prospective Studies
dc.subject Risk
dc.subject Troponin T
dc.title Relationship of T2-Weighted MRI Myocardial Hyperintensity and the Ischemic Area-At-Risk.
dc.type Journal article
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/25972514
pubs.begin-page 254
pubs.end-page 265
pubs.issue 3
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Cardiology
pubs.organisational-group Radiology
pubs.organisational-group School of Medicine
pubs.organisational-group Staff
pubs.organisational-group Temp group - logins allowed
pubs.publication-status Published
pubs.volume 117
dc.identifier.eissn 1524-4571


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