Abstract
Diffusion weighted magnetic resonance imaging (DWI) is used to identify tissue injury area in patients admitted for stroke. Limited study has been performed to evaluate its clinical interest in patients with acute ST elevation myocardial infarction (STEMI). The study included 17 patients (14 men, 55 ± 14years, 12 anterior) with a recent STEMI (<7 days) treated by percutaneous coronary intervention. A breath free ECG gated DWI sequence with increasing b values (0, 50, 100, 150 and 200 sec/mm 2 ) was applied in attempting to image myocardial injury. Hypersignal area was automatically computed from log transformed DWI sequences. The hypersignal area was compared to baseline (n = 17) and left ventricular ejection fraction (LVEF) recovery (n = 11). Large area of hypersignal correlated with impaired baseline LVEF whatever b value (r value range between 0.58 and 0.60, p < 0.05 for all). However, only hypersignal area with b = 50 sec/mm 2 correlated with LVEF recovery (r = −0.61, p < 0.05). Importantly, apparent diffusion coefficient failed to correlate with baseline and LVEF recovery. In patients with acute MI, hypersignal area from diffusion weighted magnetic resonance imaging with b = 50 sec/mm 2 seems to provide an accurate assessment of myocardial injury and may be used to predict LVEF recovery.
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