Journal
POSTEPY W KARDIOLOGII INTERWENCYJNEJ
Volume 18, Issue 4, Pages 416-422Publisher
TERMEDIA PUBLISHING HOUSE LTD
DOI: 10.5114/aic.2022.121344
Keywords
acute myocardial infarction; cardiac diffusion-weighted imaging; cardiac diffusion tensor imaging; spin-echo echo-planar imaging
Categories
Funding
- National Centre of Research and Development
- EU [STRATE-GMED2/265761/10/NCBR/2015]
- [POWR.03.02.00-00-I004/16]
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The study applied spin-echo echo planar imaging (SE-EPI) to diffusion tensor imaging (DTI) in patients with acute myocardial infarction (AMI). By using a specific method and algorithm, the study successfully obtained diffusion-weighted imaging (DWI) images showing infarct zones and quantitatively evaluated diffusion tensor parameters. The results demonstrated that the method is suitable for qualitative assessment of infarction severity and can approach the diffusion tensor parameter values reported for the myocardium, despite the lack of motion compensation blocks in the SE-EPI sequence.
Introduction: Originally thought unsuitable due to proneness to myocardial motion and susceptibility artefacts, spin-echo echo planar imaging (SE-EPI) has gained attention for the cardiac diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) offering higher SNR and lower achievable echo time (TE).Aim: The application of DTI for patients with acute myocardial infarction (AMI) using our methodology developed on the basis of the SE-EPI sequence.Material and methods: Twelve patients with AMI and six healthy controls were enrolled in the preliminary DTI study within the CIRCULATE STRATEGMED 2 project. Our method relied on a pilot ECG-triggered DTI examination, based on which the initial evaluation was possible and allowed proper manipulation of TE (64/47 ms for patients/control), repetition time (TR) and ECG trigger delay in the consecutive DTI.Results: The study demonstrated that by using our algorithm it was possible to obtain DWI images showing infarct zones identified on T1-weighted images with late gadolinium-enhancement (LGE) with division into subtle and severe damage. Quantitative DTI showed increased mean diffusivity (MD) and decreased fractional anisotropy (FA) in the infarct compared to remote tissue. The application of B-matrix spatial distribution (BSD) calibration allowed the improvement of FA.Conclusions: Our algorithm is suitable for qualitative assessment of infarction zones with different severity. The analysis of the quantitative DTI showed that despite the lack of motion compensation blocks in the applied SE-EPI sequence, it was possible to approach the diffusion tensor parameter values reported for the myocardium.
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