Diagnostic performance of T (1) and T (2) mapping to detect intramyocardial hemorrhage in reperfused ST‐segment elevation myocardial infarction (STEMI) patients

PURPOSE: To investigate the performance of T (1) and T (2) mapping to detect intramyocardial hemorrhage (IMH) in ST‐segment elevation myocardial infarction (STEMI) patients treated by primary percutaneous coronary intervention (PPCI). MATERIALS AND METHODS: Fifty STEMI patients were prospectively recruited between August 2013 and July 2014 following informed consent. Forty‐eight patients completed a 1.5T cardiac magnetic resonance imaging (MRI) with native T (1), T (2), and [Formula: see text] maps at 4 ± 2 days. Receiver operating characteristic (ROC) analyses were performed to assess the performance of T (1) and T (2) to detect IMH. RESULTS: The mean age was 59 ± 13 years old and 88% (24/48) were male. In all, 39 patients had interpretable [Formula: see text] maps and 26/39 (67%) of the patients had IMH ( [Formula: see text] <20 msec on [Formula: see text] maps). Both T (1) and T (2) values of the hypointense core within the area‐at‐risk (AAR) performed equally well to detect IMH (T (1) maps AUC 0.86 [95% confidence interval [CI] 0.72–0.99] versus T (2) maps AUC 0.86 [95% CI 0.74–0.99]; P = 0.94). Using the binary assessment of presence or absence of a hypointense core on the maps, the diagnostic performance of T (1) and T (2) remained equally good (T (1) AUC 0.87 [95% CI 0.73–1.00] versus T (2) AUC 0.85 [95% CI 0.71–0.99]; P = 0.90) with good sensitivity and specificity (T (1): 88% and 85% and T (2): 85% and 85%, respectively). CONCLUSION: The presence of a hypointense core on the T (1) and T (2) maps can detect IMH equally well and with good sensitivity and specificity in reperfused STEMI patients and could be used as an alternative when [Formula: see text] images are not acquired or are not interpretable. Level of Evidence: 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:877–886