Background: The magnetic resonance imaging of the heart provides the distinctive opportunity to non-invasively evaluating the myocardium, and has become the gold standard for the assessment of viability.
Objective: To examine the clinical application of cardiac magnetic resonance imaging (CMRI) native and post-contrast T1 map, as extensively as the T2 map, in ischemic heart disease in the form of diagnosis of myocardial edema and necrosis in cases of acute myocardial infarction post percutaneous coronary intervention (PCI), and to evaluate their prognostic value.
Patients and methods: A total number of 80 patients were scheduled for elective CMRI between December 2019 and April 2021. Our patients came to Al-Hussein Hospital, Cardiology Department with a clinical picture of an acute myocardial infarction subjected for PCI. They were referred to the CMRI unit at Al-Hussein Hospital one to two days post PCI for CMRI as a part of a research project. Follow up magnetic resonance imaging (MRI) was performed three to four months later.
Results: This study involved 59 males and 21 females with a mean age of 53 (± 12) years. In our study, different tissue mapping values showed marked statistically difference between hyper enhanced (HE) and remote segments with P value <0.001. We detected microvascular obstruction in 50 patients (62.5%). In patients with microvascular obstruction (MVO), there was a difference (yet non statistically significant) in tissue mapping values between segments of MVO and hyper enhanced segments, with no MVO with tendency towards pseudo normalization of tissue mapping values of the MVO segments. The suggested cut off value of T2 map was 53.2ms with 80% sensitivity, 71% specificity, 74% positive predictive value, 78% negative predictive value, and 76% accuracy. There were two suggested cut off value of native T1 map:
1. The first one was 1076.9 ms with 68% sensitivity, 80% specificity, 77% positive predictive value, 71% negative predictive value, and 74% accuracy.
2. The second one was 1069 ms with 75% sensitivity, 73% specificity, 73% positive predictive value, 74% negative predictive value, and 74% accuracy. The suggested cut off value of the extra cellular volume (ECV) showed 78% sensitivity, 89% specificity, 88% positive predictive value, 80% negative predictive value, and 84% accuracy.
Conclusion: The area at risk in cases of an acute coronary syndrome and suggested cut off values were with reasonable sensitivity, specificity and accuracy.