Document Detail

Bright-blood T(2)-weighted MRI has high diagnostic accuracy for myocardial hemorrhage in myocardial infarction: a preclinical validation study in swine.
MedLine Citation:
PMID:  21930836     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Myocardial hemorrhage after myocardial infarction (MI) usually goes undetected. We investigated the diagnostic accuracy of bright-blood T(2)-weighted cardiac MRI for myocardial hemorrhage in experimental MI.
METHODS AND RESULTS: MI was created in swine by occluding the left anterior descending (n=10) or circumflex (n=5) coronary arteries for 90 minutes followed by reperfusion for ≤3 days (n=2), 10 days (n=7), or 60 days (n=6). MRI was performed at 1.5 T, using bright-blood T(2)-prepared steady-state free-precession, T(2)* and early (1 minute) and late (10-15 minutes) gadolinium enhancement (EGE, LGE, respectively) MRI. Left ventricular sections and histology were assessed for hemorrhage by an experienced cardiac pathologist blinded to the MRI data. Hypointense regions on T(2)-weighted and contrast-enhanced MRI were independently determined by 3 cardiologists experienced in MRI who were also blinded to the pathology results. Eighty ventricular pathological sections were matched with MRI (n=68 for EGE MRI). All sections with evidence of MI (n=63, 79%) also exhibited hyperintense zones consistent with edema on T(2)-weighted MRI and infarct on LGE MRI. Myocardial hemorrhage occurred in 49 left ventricular sections (61%) and corresponded with signal voids on 48 T(2)-weighted (98%) and 26 LGE-MRI (53%). Alternatively, signal voids occurred in the absence of hemorrhage in 3 T(2)-weighted (90% specificity) and 5 LGE MRI (84% specificity). On EGE MRI, 27 of 43 cases of early microvascular obstruction corresponded with hemorrhage (63% sensitivity), whereas 5 of 25 defects occurred in the absence of hemorrhage (80% specificity). The positive and negative predictive values for pathological evidence of hemorrhage were 94% and 96% for T(2)-weighted, 84% and 55% for LGE MRI, and 85% and 56% for EGE MRI.
CONCLUSIONS: Bright-blood T(2)-weighted MRI has high diagnostic accuracy for myocardial hemorrhage.
Alexander R Payne; Colin Berry; Peter Kellman; Rachel Anderson; Li-Yueh Hsu; Marcus Y Chen; Allan R McPhaden; Stuart Watkins; William Schenke; Victor Wright; Robert J Lederman; Anthony H Aletras; Andrew E Arai
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2011-09-19
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  4     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-17     Completed Date:  2012-01-23     Revised Date:  2014-10-22    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  738-45     Citation Subset:  IM    
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MeSH Terms
Biopsy, Needle
Contrast Media / diagnostic use
Disease Models, Animal
Heart Diseases / diagnosis*,  etiology
Hemorrhage / diagnosis*,  etiology
Image Enhancement / methods
Magnetic Resonance Imaging / methods*
Myocardial Infarction / complications*
Myocardium / pathology*
Random Allocation
Sensitivity and Specificity
Grant Support
CZB/4/572//Chief Scientist Office; SCD/01//Chief Scientist Office; Z01-HL004607-12/HL/NHLBI NIH HHS; Z01-HL005062-08/HL/NHLBI NIH HHS; ZIA HL006136-01/HL/NHLBI NIH HHS; ZIA HL006136-02/HL/NHLBI NIH HHS; //Chief Scientist Office
Reg. No./Substance:
0/Contrast Media

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