1532-429X-13-S1-O9 1532-429X Oral presentation <p>Determination of the myocardial area at risk after reperfused acute myocardial infarction with different imaging techniques: cardiac magnetic resonance imaging, multidetector computed tomography and histopathological validation</p> Mewton Nathan Rapacchi Stanislas Augeul Lionel Ferrera René Loufouat Joseph Boussel Loic Rioufol Gilles Revel Didier Ovize Michel Croisille Pierre

Hôpital Cardiovasculaire Louis Pradel, LYON, France

CREATIS-LRMN, CNRS UMR 5220 – INSERM U630 – Université Claude Bernard Lyon 1, Lyon, France

Inserm U886 Cardioprotection, Université Claude Bernard Lyon1, Lyon, France

Hôpital Cardiovasculaire Louis Pradel/ CREATIS-LRMN, CNRS UMR 5220 – INSERM U630 – Université Claude Bernard Lyon 1, Lyon, France

 Journal of Cardiovascular Magnetic Resonance <p>Abstracts of the 2011 SCMR/Euro CMR Joint Scientific Sessions</p> Meeting abstracts - A single PDF containing all abstracts in this supplement is available here. <p>2011 SCMR/Euro CMR Joint Scientific Sessions</p> Nice, France 3-6 February 2011 http://www.scmr.org/ 1532-429X 2011 13 Suppl 1 O9 http://jcmr-online.com/content/13/S1/O9 10.1186/1532-429X-13-S1-O9 2 2 2011 2011 Croisille et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction

The myocardial area at risk (AAR) is a major determinant of infarct size. Which imaging technique is the most appropriate to accurately measure its size remains debated.

Purpose

The principal objective of this study was to compare the AAR defined with two different T2 weighted cardiac magnetic resonance (T2W CMR) imaging sequences (TIRM T2w blood suppressed TSE and ACUTE TSE-SSFP), the contrast-enhanced (ce-) CMR endocardial surface length (ESL) after 90-minutes of reperfusion and the arterial enhanced multi-detector computed tomography (MDCT) performed during occlusion with the reference histological AAR delineated after injection of uniperse blue dye in reperfused myocardial infarction.

Methods

Fifteen closed-chest pigs underwent a 40-minutes coronary artery occlusion (angioplasty balloon inflation), followed by reperfusion. Three co-registered short-axis slices (base, mid-ventricle, apex) were obtained for each animal and each imaging technique for statistical analysis (Figures 1 and 2).

<p>Figure 1</p>

<p>Figure 2</p>

Results

The best fit with the reference histological AAR was obtained for the hypoenhanced area on arterial enhanced MDCT (R2=0.56; P<0.05) with a small bias on Bland-Altman plots (5.7±11% LV area). The AAR as defined by both T2W TIRM and ACUTE sequences or the ESL on ce-CMR significantly overestimated the size of the AAR by pathology with only a fair correlation (R2=0.37, R2=0.40 and R2=0.42; P<0.05 respectively) and important bias (27.2 ± 11.0% LV area; 22.6 ± 11.2% LV area 16.0±11.3% respectively).

Conclusions

Arterial enhanced MDCT performed at the time of occlusion was the most accurate method to assess the AAR, whereas T2wCMR and the contrast enhanced ESL performed 90 minutes after reperfusion significantly overestimated the AAR.