Document Detail


3D and 2D delayed-enhancement magnetic resonance imaging for detection of myocardial infarction: preclinical and clinical results.
MedLine Citation:
PMID:  17574129     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
RATIONALE AND OBJECTIVES: The purpose was to verify whether myocardial viability can be detected by a delayed enhancement magnetic resonance imaging (MRI) approach using a rapid three-dimensional inversion-recovery fast low-angle shot (3D IR-FLASH) sequence in a preclinical and clinical setting. MATERIALS AND METHODS: Nonreperfused myocardial infarctions were induced in eight minipigs. Both the pigs and 15 patients with suspected myocardial infarction underwent MRI using a rapid 3D IR-FLASH sequence and a two-dimensional IR-FLASH sequence as the reference standard. RESULTS: In the pigs, a total of 52 segments with myocardial infarction were identified with both sequences and there was good agreement in transmurality of 99.5%. The infarction volume determined with the 3D IR-FLASH in the animal study (2.4 +/- 1.5 cm(3)) showed a good correlation with the histomorphometrically determined volume using triphenyltetrazolium chloride (2.3 +/- 1.2 cm(3), r = 0.98, P < .001) and the two-dimensional IR-FLASH sequence (2.3 +/- 1.4 cm(3), r = 0.99, P < .001). Eleven of 15 patients were found to have myocardial infarction in 37 myocardial segments with both sequences and there was a good agreement in transmurality of 98.8%. There was also a good correlation in the clinical study between the 3D and 2D sequences (6.9 +/- 6.7 cm(3) vs. 6.8 +/- 6.5 cm(3), r = 0.98, P < .001). In Bland-Altman analysis there was no significant under- or overestimation of the myocardial infarction volume using the 3D IR-FLASH sequence in comparison to the two-dimensional reference standard in both the preclinical and clinical study. The contrast-to-noise ratios were not significantly different between 3D and 2D sequences in the animal (34.7 +/- 1.5 vs. 33.8 +/- 2.6; P = .51) and clinical study (31.4 +/- 12.5 vs. 36.7 +/- 11.5; P = .31). The breathhold time for the 3D IR-FLASH sequence in the clinical study (20.4 +/- 2.2 s) was significantly shorter than that of the 2D IR-FLASH sequence (190.1 +/- 20.8 s, P < .001). CONCLUSIONS: The rapid 3D IR-FLASH sequence detects myocardial infarction with high accuracy and allows a relevant reduction in acquisition time.
Authors:
Daniel Peukert; Michael Laule; Matthias Taupitz; Nicola Kaufels; Bernd Hamm; Marc Dewey
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Academic radiology     Volume:  14     ISSN:  1076-6332     ISO Abbreviation:  Acad Radiol     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-18     Completed Date:  2007-08-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440159     Medline TA:  Acad Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  788-94     Citation Subset:  IM    
Affiliation:
Department of Radiology, Charité, Humboldt Universität zu Berlin, Institut für Radiologie, Charitéplatz 1, 10117 Berlin, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Animals
Chronic Disease
Contrast Media / administration & dosage
Female
Gadolinium DTPA / diagnostic use
Heterocyclic Compounds / diagnostic use
Humans
Image Enhancement / methods*
Image Processing, Computer-Assisted / methods
Imaging, Three-Dimensional / methods*
Magnetic Resonance Imaging / methods*
Male
Myocardial Infarction / diagnosis*
Organometallic Compounds / diagnostic use
Predictive Value of Tests
Reference Standards
Reproducibility of Results
Sensitivity and Specificity
Swine
Swine, Miniature
Time Factors
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Heterocyclic Compounds; 0/Organometallic Compounds; 80529-93-7/Gadolinium DTPA; 92923-44-9/gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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