Myocardial Fat Deposition after Left Ventricular Myocardial Infarction: Assessment by Using MR Water-Fat Separation Imaging

Goldfarb, James W.; Roth, Marguerite; Han, Jing

doi:10.1148/radiol.2532082290

Cited by 67 publications

(72 citation statements)

References 35 publications

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“…Magnetic field heterogeneity in the area of the valve is probably responsible for the artifactual epicardial enhancement in the area of the valve plane, in the vicinity of the inferior wall. Finally, note that heterogeneities at the LV apex, within the infarct core, is caused by interstitial fat deposition, patterns often described in chronic infarct and previously reported (40).…”

Section: Comparison Of Ir-bssfp (Psir B-ssfp) and Ir-gre (Respiratorysupporting

confidence: 61%

Head‐to‐head comparison of eight late gadolinium‐enhanced cardiac MR (LGE CMR) sequences at 1.5 tesla: From bench to bedside

Viallon

Jacquier

Rotaru

et al. 2011

Magnetic Resonance Imaging

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Purpose: To compare-theoretically and experimentallyclinically available two-dimensional/three-dimensional (2D/3D), breathhold and non-breathhold, inversionrecovery (IR) gradient-echo (GRE) sequences used to differentiate between nonviable injured and normal myocardium with late gadolinium-enhanced techniques (IR-GRE2D sequence is used as a reference), and to evaluate their respective clinical benefit. Materials and Methods:Six breathhold (2D-IR-GRE, 3D-IR-GRE, balanced steady-state free precession 2D-IRbSSFP and 3D-IR-bSSFP, phase-sensitive 2D-PSIR-GRE, and 2D-PSIR-bSSFP) and two non-breathhold late gadolinium-enhanced techniques (single-shot 2D-ssbSSFP and 2D-PSIR-ssbSSFP) were consecutively performed in 32 coronary artery disease patients with chronic myocardial infarction. Qualitative assessment and manual planimetry were performed by two independent observers. Quantitative assessment was based on percentage signal intensity elevation between injured and normal myocardium and contrast-to-noise ratio. Theoretical simulations were compared with experimental measurements performed on phantoms with various concentrations of gadolinium.Results: The 3D-IR-GRE image quality appeared better than the other 2D and 3D sequences, showing better delineation of complex nontransmural lesions, with significantly higher percentage signal intensity and contrast-tonoise ratio. PSIR techniques appeared more limited in differentiating sub-endocardial lesions and intracavity blood pool, but in all other cases were comparable to the other techniques. Single-shot PSIR-ssbSSFP appeared to be a valuable alternative technique when breathhold cannot be achieved. Conclusion:We recommend 3D-IR-GRE as the method of choice for late gadolinium-enhanced cardiac magnetic resonance imaging in clinical practice.

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Section: Comparison Of Ir-bssfp (Psir B-ssfp) and Ir-gre (Respiratorysupporting

confidence: 61%

Head‐to‐head comparison of eight late gadolinium‐enhanced cardiac MR (LGE CMR) sequences at 1.5 tesla: From bench to bedside

Viallon

Jacquier

Rotaru

et al. 2011

Magnetic Resonance Imaging

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“…Moreover, the pattern of presentation of metaplasic fat in infarction is different than in ARVC. In fact, in fat metaplasia of old ischemic scar, fat is usually identified in the core of transmural scar and then it is usually localized in the mid-wall [15]. Fat infiltration/substitution which characterizes ARVC is usually located in the sub-epicardial layer, starting the invasion of myocardium from the epicardial fat [3,16].…”

Section: Discussionmentioning

confidence: 99%

Fat in left ventricular myocardium assessed by steady-state free precession pulse sequences

Aquaro

Nucifora

Pederzoli

et al. 2011

Int J Cardiovasc Imaging

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Intramyocardial fat can be observed in different pathologic processes including arrhythmogenic right ventricular cardiomyopathy (ARVC) and in old myocardial infarction (OMI) In SSFP images, fat is hyperintense and surrounded by a black boundary, called "Indian Ink" artifact that is generated when fat and water coexist in the same voxel. Aim of this study was to compare the SSFP with the conventional FSE and STIR (FSE/STIR) method for the detection of LV intramyocardial fat. Fifty-four consecutive patients with OMI (>1,000 days) and 69 patients with a diagnosis of ARVC underwent magnetic resonance. LV fat was detected in 29 patients (53.7%) in SSFP images and in 28 patients (51.9%) in FSE/STIR images. At Bland- Altman plot a close agreement was found between the extent of fat measured in SSFP images and in FSE images. However, a slight systematic overestimation, was found for the fat quantification in the SSFP images. In the ARVC group, both FSE/STIR and SSFP images evidenced fat infiltration in LV myocardium in 11 patients (15.9%) without any mismatch. SSFP had 100% sensitivity and 98.8% of specificity to detect LV intramyocardial fat in ARVC and in ischemic heart disease. SSFP sequence with TR/TE = 2 is capable in identifying and quantifying the presence of fat tissue within the LV myocardium in patients with previous myocardial infarction and ARVC.

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“…The presence of myocardial fatty or fibrofatty infiltration is not included in either the revised or the original task force criteria because of (a) artifactual fat resulting from limited imaging techniques (22) and (b) the presence of fatty infiltration in physiologic (20)(21)(22)(23)(24) and other pathologic states, such as healed myocardial infarction (18,(24)(25)(26)(27)(28)(29)(30) (Fig 3), cardiac lipoma (31,32), lipomatous hypertrophy of the interatrial septum (33), tuberous sclerosis complex (34), and dilated cardiomyopathy. Isolated and marked lipomatous infiltration of the RV appears to be a separate condition from ARVC (35).…”

Section: Normal Variants Mischaracterized As Findings Of Arvc Myocardmentioning

confidence: 99%

Cardiac MR Findings and Potential Diagnostic Pitfalls in Patients Evaluated for Arrhythmogenic Right Ventricular Cardiomyopathy

Rastegar¹,

Burt

Corona‐Villalobos

et al. 2014

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Myocardial Fat Deposition after Left Ventricular Myocardial Infarction: Assessment by Using MR Water-Fat Separation Imaging

Abstract: There is a high prevalence of fat deposition in healed MI. It is associated with post-infarction characteristics including infarct volume, LV mass, wall thickness, wall thickening, and wall motion.

Cited by 67 publications

References 35 publications

Head‐to‐head comparison of eight late gadolinium‐enhanced cardiac MR (LGE CMR) sequences at 1.5 tesla: From bench to bedside

Head‐to‐head comparison of eight late gadolinium‐enhanced cardiac MR (LGE CMR) sequences at 1.5 tesla: From bench to bedside

Fat in left ventricular myocardium assessed by steady-state free precession pulse sequences

Cardiac MR Findings and Potential Diagnostic Pitfalls in Patients Evaluated for Arrhythmogenic Right Ventricular Cardiomyopathy

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