Identifying different heart tissues from combined functional and viability MRI images

Assessment of myocardial viability in patients with myocardial infarction (MI) is important for therapeutic decision making. Magnetic resonance imaging (MRI) delayed-enhancement (DE) images provide accurate myocardial viability images. In addition, functional MRI provides important complementary information about the heart muscle status. From the combined viability and functional images, different tissue types of the heart could be identified using clustering techniques. However, seldom are these MRI images acquired at the same point in time to allow for automatic clustering. Composite strain-encoding (C-SENC) MRI is a modification of the standard SENC MRI, which enables acquiring both viability and functional images in the same cardiac phase. A multi-stage clustering technique was applied to the resulting C-SENC images of canine models with MI as well as to human volunteers and patients with MI. The results showed the applicability of the proposed technique for identifying different heart tissues: normal myocardium, infarction, and blood.