Document Detail

Assessment of myocardial viability by MR imaging.
MedLine Citation:
PMID:  12541110     Owner:  NLM     Status:  MEDLINE    
Diagnosis of myocardial viability after infarction focuses on the prediction of functional improvement of dysfunctional myocardium after revascularization therapy. Magnetic resonance imaging provides different approaches for the detection of myocardial viability. Measurement of end-diastolic wall thickness is easy to perform and has a high sensitivity, but a low specificity, and can only be used 4 months after myocardial infarction due to infarct healing processes. Low-dose dobutamine stress has a good sensitivity with a high specificity for the prediction of wall motion improvement, but this is only true for patients with a singular dysfunctional area and only slightly depressed cardiac function. Late enhancement allows for direct visualization of necrotic or scarred tissue. By measuring the transmural extent of late enhancement, the probability of mechanical improvement can precisely be given. Imaging of microvascular obstruction by first-pass perfusion or late enhancement gives additional information on viability and patient prognosis. Metabolic imaging techniques, such as (31)P-MR spectroscopy and (23)Na-MR imaging, provide further insights into the mechanisms of myocardial infarction and viability. In conclusion, cardiac MRI offers several clinically usable approaches for the assessment of myocardial viability and will probably become the method of choice in the near future.
Jörn J W Sandstede
Publication Detail:
Type:  Journal Article     Date:  2002-10-23
Journal Detail:
Title:  European radiology     Volume:  13     ISSN:  0938-7994     ISO Abbreviation:  Eur Radiol     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-01-23     Completed Date:  2003-05-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  52-61     Citation Subset:  IM    
Institut für Röntgendiagnostik, Bayerische Julius-Maximilians-Universität Würzburg, Klinikstrasse 8, 97070 Würzburg, Germany.
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MeSH Terms
Contrast Media
Dobutamine / diagnostic use
Gadolinium DTPA / diagnostic use
Magnetic Resonance Imaging*
Magnetic Resonance Imaging, Cine
Magnetic Resonance Spectroscopy
Middle Aged
Myocardial Contraction*
Myocardial Infarction / pathology,  physiopathology*,  therapy
Myocardial Revascularization
Myocardium / metabolism,  pathology*
Sensitivity and Specificity
Reg. No./Substance:
0/Contrast Media; 34368-04-2/Dobutamine; 80529-93-7/Gadolinium DTPA

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