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In cardiac magnetic resonance (MR), T2* mapping is the reference standard for detecting IMH while cardiac diffusion tensor imaging (cDTI) can characterize myocardial architecture via fractional anisotropy (FA) and mean diffusivity (MD) of water molecules. The value of cDTI in the detection of IMH is not currently known.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>cDTI can detect IMH post\u2010STEMI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Prospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects<\/jats:title><jats:p>A total of 50 patients (20% female) scanned at 1\u2010week (V1) and 3\u2010month (V2) post\u2010STEMI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>A 3.0\u2009T; inversion\u2010recovery <jats:styled-content style=\"fixed-case\">T1<\/jats:styled-content>\u2010weighted\u2010imaging, multigradient\u2010echo <jats:styled-content style=\"fixed-case\">T2<\/jats:styled-content>* mapping, spin\u2010echo <jats:styled-content style=\"fixed-case\">cDTI<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>T2* maps were analyzed to detect IMH (defined as areas with T2*\u2009&lt;\u200920\u2009msec within areas of infarction). cDTI images were co\u2010registered to produce averaged diffusion\u2010weighted\u2010images (DWIs), MD, and FA maps; hypointense areas were manually planimetered for IMH quantification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistics<\/jats:title><jats:p>On averaged DWI, the presence of hypointense signal in areas matching IMH on T2* maps constituted to true\u2010positive detection of iron. Independent samples <jats:italic>t<\/jats:italic>\u2010tests were used to compare regional cDTI values. Results were considered statistically significant at <jats:italic>P<\/jats:italic>\u2009\u2264\u20090.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At V1, 24 patients had IMH on T2*. On averaged DWI, all 24 patients had hypointense signal in matching areas. IMH size derived using averaged\u2010DWI was nonsignificantly greater than from T2* (2.0\u2009\u00b1\u20091.0\u2009cm<jats:sup>2<\/jats:sup> vs 1.89\u2009\u00b1\u20090.96\u2009cm<jats:sup>2<\/jats:sup>, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.69). Compared to surrounding infarcted myocardium, MD was significantly reduced (1.29\u2009\u00b1\u20090.20\u00a0\u00d7\u200910<jats:sup>\u22123<\/jats:sup>\u00a0mm<jats:sup>2<\/jats:sup>\/sec vs 1.75\u2009\u00b1\u20090.16\u00a0\u00d7\u200910<jats:sup>\u22123<\/jats:sup>\u00a0mm<jats:sup>2<\/jats:sup>\/sec) and FA was significantly increased (0.40\u2009\u00b1\u20090.07 vs 0.23\u2009\u00b1\u20090.03) within areas of IMH. By V2, all 24 patients with acute IMH continued to have hypointense signals on averaged\u2010DWI in the affected area. T2* detected IMH in 96% of these patients. Overall, averaged\u2010DWI had 100% sensitivity and 96% specificity for the detection of IMH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>This study demonstrates that the parameters MD and FA are susceptible to the paramagnetic properties of iron, enabling cDTI to detect IMH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Evidence Level<\/jats:title><jats:p>1<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy<\/jats:title><jats:p>Stage 2<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.28063","type":"journal-article","created":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T12:14:01Z","timestamp":1641989641000},"page":"1171-1181","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Detection of Intramyocardial Iron in Patients Following <scp>ST<\/scp>\u2010Elevation Myocardial Infarction Using Cardiac Diffusion Tensor 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