Assessment of tissue edema in patients with acute myocardial infarction by computer-assisted quantification of triple inversion recovery prepared MRI of the myocardium

The aim of this study was to design a computer algorithm to assess the extent of cardiac edema from triple inversion recovery MR images of the human left ventricular myocardium. Twenty-one patients presenting with acute myocardial infarction were scanned within 48 h of the onset of symptoms. Eight patients were scanned a second time, 4 weeks after the initial event. Myocardial edema was detected in 27 of 29 studies using visual contour-based manual segmentation. A reference standard, created from the segmentations of three raters by voxel-wise majority voting, was compared to the edema mass estimates obtained using a newly developed computer algorithm. At baseline (n = 20), the reference standard yielded an edema mass of 16.4 ± 15.0 g (mean ± SD) and the computer algorithm edema mass was 16.4 ± 12.6 g. At follow-up (n = 7), the reference standard edema mass was 7.1 ± 4.4 g compared to 16.3 ± 7.7 g at baseline. Computer algorithm estimates showed the same pattern of change with 5.7 ± 5.7 g at follow-up compared to 20.8 ± 13.8 g at baseline. Although there was a significant degree of discrepancy between reference standard and computer algorithm estimates of edema mass in individual patients, their overall agreement was good, with intraclass correlation coefficient ICC(3, 1) = 0.753. Magn Reson Med, 2010