No Reflow (NR) phenomenon is a well known negative prognostic factor for STEMI pts (Ref 1), it is due to several factors, among them intramyocardial hemorrhage (IMH) plays an important role. IMH seems to be associated with worse infarction and adverse outcome, even if its incidence and its role need to be confirmed (Ref 2). Our aim was to investigate the ability to detect IMH through T2 STIR and T2*.

All STEMI pts enrolled in our study underwent percutaneous coronary intervention (PCI) within 12 hours from symptoms onset and CMR within 5 days from the acute event. All pts underwent a CMR examination with Late Gadolinium Enhancement sequences (LGE) and T2 STIR sequences, a subgroup underwent also T2* images (TR:12,24; TE: 9,197 and TR:12,24;TE: 4,6). CMR criteria for NR was the presence of a hypointense region within the infarcted area on LGE. IMH was visualized on T2 STIR and T2* as an hypointense region within...

55 pts were enrolled in the study, 22 of whom underwent also T2*. Thirty-eight pts out of 55 had NR at LGE (65%), and 18 pts of them had hemorrage on T2 STIR (31%). In the subgroup of 22 pts who underwent T2*, 13 had evidence of NR at LE, 8 pts showed IMH at T2 STIR, and 10 showed IMH at T2*. All pts with IMH had NR at LGE. All pts with hemorrage on T2 STIR had hemorrage also at T2*, and the...

All pts with IMH had NR at LGE. All pts with hemorrage on T2 STIR had hemorrage also at T2*, and the percentage of IMH was higher in T2* sequences than in T2 STIR (T2*: 3.09% ± 2.42 ; T2 STIR: 1.00% ± 1.92) . Two pts had evidence of IMH on T2* without having IMH on T2 STIR.

Reference 1: Kloner R.; No-Reflow Phenomenon: Maintaining Vascular Integrity. Journal of Cardiovascular Pharmacology and Therapeutics 2011. Reference 2: Kidambi et Al. The effect of microvascular obstruction and intramyocardial hemorrage on contractile recovery in reperfused myocardial infarction: insights from cardiovascular magnetic resonance. Journal of Cardiovascular Magnetic Resonance 2013.