The relationship of the transmural extent of T2-edema compared with the transmural extent of infarction: implications for the assessment of the area-at-risk

Background It has been reported that hyperintensity on T2W-CMR represents the area-at-risk. This conclusion is based upon the observation that the region of T2-hyperintensity is always larger than region of infarction. However, differences in measured size may be due to many factors, including the choice of different image intensity thresholds (Nat Rev Cardiol. 2010 Oct;7(10):547-9.). Additionally, basic physiology studies have established that the area-at-risk is not simply larger than the region of infarction, but is nearly always transmural regardless of the transmurality of infarct size. The relationship between the transmural extent of T2-hyperintensity and the transmural extent of infarction is unknown.