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3.0T MultiTransmit Cardiac MR of acute myocardial infarction

Case Study
Thomas, Daniel, M.D., Ph.D. University of Bonn • Germany

Patient history

39-year-old male was referred to the emergency department with retrosternal burning. ECG without abnormalities. Cardiac biomarkers elevated (Troponin I 34 ng/ml, CK-MB 24 µg/l). Coronary angiography revealed chronic occlusion of left circumflex artery and acute occlusion of the right coronary artery, most likely based on a subtotal stenosis. Attempts of interventional recanalization were unsuccessful. Patient was referred to cardiac MR prior to bypass surgery.

MR examination

3.0T MultiTransmit was used with 6-channel SENSE Cardiac coil.

B-FFE (SSFP) cine was done with FOV 360 mm, matrix 160 x 144, slice thickness 8 mm, flip angle 45°, TR 2.7 ms, TE 1.4 ms. Cine sequences allow qualitative and quantitative determination of ventricular dysfunction.
T2 TSE STIR was done with FOV 320 mm, matrix 204 x 138, slice thickness 8 mm, TR 1739 ms, TE 60 ms). T2 STIR weighted imaging reveals the extent of myocardial edema.

Viability imaging was done with a 3D T1-weighted TFE sequence with adiabatic inversion pulse, flip angle 10°, TR 4.2 ms, TE 1.3 ms, temporal resolution 1.3 ms.
The extent of transmural myocardial necrosis determined by delayed enhancement imaging gives information on success of  revascularization.  


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 Viability Viability T2 TSE STIR

The B-FFE cine images show akinesis and hypokinesis of the basal and midventricular inferior, inferolateral and inferoseptal segments. Hypokinesis can also be found in anterolateral segments.

Corresponding to the wall motion abnormalities, viability imaging reveals the typical pattern of ischemic scar tissue in the abovementioned myocardial segments. The basal inferior segments show a transmural infarction of 50-75% and the midventricular segments of 25-50%.

T2 TSE STIR imaging shows a mainly basally localized myocardial edema of the lateral wall.


Acute myocardial infarction mainly in the territory of the right coronary artery. Patient received coronary bypass grafts. Postoperatively LV function improved (EF 56% vs 46%).

Clinical value of cardiac MR with MultiTransmit

3.0T Cardiac MRI with MultiTransmit allows a comprehensive characterization of the acute myocardial infarction in this patient. Note the excellent signal uniformity provided by MultiTransmit.

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Dec 7, 2011

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Case Study
3.0T, Cardiac, MultiTransmit, Myocardial infarction

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