Automatic fuzzy classification of the washout curves from magnetic resonance first-pass perfusion imaging after myocardial infarction

Invest Radiol. 2005 Aug;40(8):545-55. doi: 10.1097/01.rli.0000170448.31487.1b.

Abstract

Objectives: We sought to investigate the diagnostic ability of cardiac magnetic resonance imaging (MRI) perfusion in acute reperfused myocardial infarction. The study used fuzzy logic to automatically classify signal intensity-time curves from myocardial segments into 3 categories: normal, hypointense, and Hyperintense.

Materials and methods: Thirty-eight patients with myocardial infarction underwent short-axis cine-MRI and contrast-enhanced MRI to provide data on wall thickening and the transmural extent of infarction. Of these, 17 had a second cardiac MRI to ascertain the functional recovery in each segment.

Results: The fuzzy logic based classification performs well (kappa= 0.87, P < 0.01) in comparison with a visual approach. Segments providing "hypo" curves do not recover (Delta = 0.11 SD = 0.96) whereas segments demonstrating the other curve types recover (Delta = 1 SD = 1.98 for "hyper" curves and Delta = 1.54 SD = 1.77 for "normal" curves).

Conclusions: The proposed automatic signal intensity-time curve classification has a prognostic value when studying the functional recovery of pathologic segments and clearly identifies the no-reflow phenomenon known to induce poor recovery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media
  • Female
  • Fuzzy Logic*
  • Humans
  • Image Processing, Computer-Assisted*
  • Magnetic Resonance Imaging, Cine*
  • Male
  • Middle Aged
  • Myocardial Infarction / pathology*
  • Myocardial Reperfusion
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Statistics, Nonparametric

Substances

  • Contrast Media