T2-prepared SSFP improves diagnostic confidence in edema imaging in acute myocardial infarction compared to turbo spin echo

T-2-weighted MRI of edema in acute myocardial infarction (MI) provides a means of differentiating acute and chronic MI, and assessing the area at risk of infarction. Conventional T-2-weighted imaging of edema uses a turbo spin-echo (TSE) readout with darkblood preparation. Clinical applications of darkblood TSE methods can be limited by artifacts such as posterior wall signal loss due to through-plane motion, and bright subendocardial artifacts due to stagnant blood. Single-shot imaging with a T-2-prepared SSFP readout provides an alternative to dark-blood TSE and may be conducted during free breathing. We hypothesized that T-2-prepared SSFP would be a more reliable method than dark-blood TSE for imaging of edema in patients with MI. In patients with MI (22 acute and nine chronic MI cases), T-2-weighted imaging with both methods was performed prior to contrast administration and delayed enhancement imaging. The T-2-weighted images using TSE were nondiagnostic in three of 31 cases, while six additional cases rated as being of diagnostic quality yielded incorrect diagnoses. In all 31 cases the T-2-prepared SSFP images were rated as diagnostic quality, correctly differentiated acute or chronic MI, and correctly determined the coronary territory. Free-breathing T-2-prepared SSFP provides T-2-weighted images of acute MI with fewer artifacts and better diagnostic accuracy than conventional dark-blood TSE.