Impact of Low Signal Intensity Assessed by Cine Magnetic Resonance Imaging on Detection of Poorly Viable Myocardium in Patients with Prior Myocardial Infarction

Abstract

Late gadolinium enhancement magnetic resonance imaging (LGE-MRI) has been established as a modality to detect myocardial infarction (MI). However, the use of gadolinium contrast is limited in patients with advanced renal dysfunction. Although the signal intensity (SI) of infarct area assessed by cine MRI is low in some patients with prior MI, the prevalence and clinical significance of low SI has not been evaluated. The aim of this study was to evaluate how low SI assessed by cine MRI may relate to the myocardial viability in patients with prior MI. Fifty patients with prior MI underwent both cine MRI and LGE-MRI. The left ventricle was divided into 17 segments. The presence of low SI and the wall motion score (WMS) of each segment were assessed by cine MRI. The transmural extent of infarction was evaluated by LGE-MRI. LGE was detected in 329 of all 850 segments (39%). The low SI assessed by cine MRI was detected in 105 of 329 segments with LGE (32%). All segments with low SI had LGE. Of all 329 segments with LGE, the segments with low SI showed greater transmural extent of infarction (78 [72 - 84] % versus 53 [38 - 72] %, P < 0.01), thinner wall (4.0[3.1 - 4.8] mm versus 6.5 [5.2 - 8.1] mm, P < 0.01), and higher WMS (4.0 [4.0 - 4.0] versus 2.0 [2.0 - 3.0], P < 0.01). The low SI assessed by cine MRI may be effective for detecting poorly viable myocardium in patients with prior MI.