Single-Shot Steady-State Free Precession Can Detect Myocardial Edema in Patients: A Feasibility Study

Purpose: To demonstrate the ability of single-shot, T-2/T-1 weighted steady-state free precession (SSFP) to detect myocardial edema in patients with an acute myocardial infarction. Materials and Methods: This study was performed in a series of patients (n = 10) referred for the assessment of acute myocardial infarcts (AMI). Localizers were used to obtain true short axis views of the left ventricle (LV). These views were used to plan and obtain T-2-weighted STIR (short TI inversion recovery) images of the LV. These slices were then acquired using single-shot dark blood-prepared SSFP with a large (31) number of dummy pulses. Lastly, Contrast agent was injected, and late enhancement (LE) images were acquired. Images were analyzed using a multi-segment model of the heart. SSFP images were compared with STIR images, with STIR images used as the standard of truth for the presence of edema. LE images were used to identify segments which were positive for microvascular obstruction. Results: All techniques were successful in all patients. A total of 312 segments were analyzed. Excluding segments positive for microvascular obstruction, SSFP had a sensitivity/specificity of 80%/89%. Including segments positive for microvascular obstruction, sensitivity/specificity was 71.%/88%. On a patient-based analysis, no AMI was missed using SSFP (sensitivity = 100%). Conclusion: Using single-shot SSFP to detect myocardial edema in patients with AMI is feasible with a moderate sensitivity and high specificity.