Free-breathing Semi-automated Quantitation of Area-at-risk Size in Patients with Acute Myocardial Infarction

Objective Non-viable myocardium can be detected using the late enhancement magnetic resonance imaging (MRI) technique [1]. Recently, T2weighted MRI scans of myocardial edema representing the area at risk in acute myocardial infarction has been introduced [2]. To improve visualization of edematous or hyperenhanced myocardium, blood is often nulled employing black-blood techniques such as a dual-inversion recovery prepulse. However, areas of slow blood-flow in the left ventricular cavity due to reduced left ventricular function will often display enhancement due to insufficient suppression of the blood. Balanced Steady State Free Precession (B-SSFP) is often employed in cardiac examinations due to the excellent contrast between blood and myocardium caused by a combination of T1 and T2 relaxation effects. We sought to investigate the use of B-SSFP scans to segment the myocardium accurately to improve depiction of the area at risk in acute myocardial infarction.