Differentiation of acute myocardial infarction from chronic myocardial scar with MRI

The coherent steady-state free precession (SSFP) pulse sequence is increasingly being used in cine imaging for evaluating the cardiac function. Compared to the spoiled gradient echo MRI, which has usually been performed for cardiac cine imaging, the SSFP imaging sequence provides a higher signal-to- noise ratio (SNR) by recycling the residual transverse magnetization, and there is less of an inflow effect by using a very short repetition time. A few studies have recently reported that contrast-enhanced (CE) cine-SSFP imaging could be used for estimating the viability of infarcted myocardium with or without the simultaneous evaluation of the ventricular function. Since the contrast of the SSFP sequence imaging is based on the ratio of T2 to T1, T1-shortening contrast-enhancement is shown as hyperenhancement, which is similar to that in the delayed-enhanced T1-imaging. In this issue of the Korean Journal of Radiology, Kim et al. have reported that the CE-cine-SSFP sequence could be used for differentiating the acutely infarcted myocardium from chronic myocardial scar with a sensitivity of 95.8%. This was a new approach for evaluating the age of myocardial infarction (MI) by using MRI