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Myocardial scar characterization & its relation to ventricular arrhythmias

Jay Detsky, PhD candidate

My project aims to improve the methods for using MR imaging to identify and classify myocardial infarct (scar tissue in the heart). Real-time MRI methods for infarct imaging expand the patient population that can successfully be examined with MR viability imaging. A new pulse sequence called multi-contrast delayed enhancement (MCDE) imaging has been developed in order to better visualize infarcted tissue (see figure below). This sequence allows for simultaneous visualization of viability and wall motion information. The scar tissue can be seen in a number of images with varying contrast, providing better delineation of the infarct-blood border. Image processing tools analyze MCDE images in order to classify and segment the infarct into two components: areas of core infarct and heterogeneous infarct. We are examining measures of infarct heterogeneity to better identify patients more likely to be susceptible to potentially fatal ventricular arrhythmias.


Top four images: MCDE images with varying contrast showing the infarcted tissue
Bottom four images: wall motion information

Publications

  1. Detsky JS, Graham JJ, Vijayaraghavan R, Biswas L, Stainsby JA, Guttman MA, Dick AJ, Wright GA. Free-breathing, non-gated real-time delayed enhancement MRI of myocardial infarcts: a comparison with conventional delayed enhancement. Accepted by Journal of Magnetic Resonance Imaging, March 2008.
  2. Detsky JS, Stainsby JA, Vijayaraghavan R, Graham JJ, Dick AJ, Wright GA. Inversion recovery-prepared SSFP for cardiac-phase-resolved delayed enhancement MRI. Magnetic Resonance in Medicine, 58(2):365-372, Aug 2007.
  3. Detsky JS, Dick AJ, Wright GA. Robust segmentation and classification of heterogeneous myocardial infarct zones. 16th meeting of the International Society for Magnetic Resonance in Medicine (ISMRM), May 2008, Toronto, Canada (e-poster).
  4. Detsky JS, Stainsby JA, Dick AJ, Wright GA. Characterization of infarct heterogeneity by fuzzy clustering. 11th meeting of the Society for Cardiovascular Magnetic Resonance (SCMR), Feb 2008, Los Angeles, USA (oral presentation).
  5. Detsky JS, Stainsby JA, Vijayaraghavan R, Graham JJ, Dick AJ, Wright GA. Inversion recovery-prepared SSFP for cardiac-phase-resolved delayed enhancement imaging. 15th meeting the ISMRM, May 2007, Berlin, Germany (e-poster).
  6. Detsky JS, Graham JJ, Vijayaraghavan R, Stainsby JA, Dick AJ, Wright GA. Real-time delayed enhancement viability imaging. 10th meeting of the SCMR, Feb 2007 Rome, Italy (poster presentation).