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Determination of Location, Size and Transmurality of Chronic Myocardial Infarction Without Exogenous Contrast Media Using Cardiac Magnetic Resonance Imaging at 3T.
MedLine Citation:
PMID:  24682268     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -LGE CMR is a powerful method for characterizing MI, but the requisite gadolinium infusion is estimated to be contraindicated in nearly 20% of MI patients due to end-stage chronic kidney disease. The purpose of this study is to investigate whether T1 Cardiovascular-Magnetic-Resonance Imaging (CMR) obtained without contrast agents at 3T could be an alternative to Late-Gadolinium-Enhanced (LGE) CMR for characterizing chronic myocardial infarctions (MIs) using a canine model of MI.
METHODS AND RESULTS: -Canines (n=29) underwent CMR at 7 days (acute, AMI) and 4 months (chronic, CMI) post-MI. Infarct location, size and transmurality measured using native T1 maps and LGE images at 1.5T and 3T were compared. Resolution of edema between AMI and CMI was examined with T2 maps. T1 maps overestimated infarct size and transmurality relative to LGE images in AMI (p=0.016 and p=0.007, respectively), which was not observed in CMI (p=0.49 and p=0.81, respectively), at 3T. T1 maps underestimated infarct size and transmurality relative to LGE images in AMI and CMI (p<0.001), at 1.5T. Relative to the remote territories, T1 of the infarcted myocardium was increased in CMI and AMI (p<0.05); and T2 of the infarcted myocardium was increased in AMI (p<0.001), but not in CMI (p >0.20) at both field strengths. Histology showed extensive replacement fibrosis within the CMI territories. CMI detection sensitivity and specificity of T1 CMR at 3T were 95% and 97%, respectively.
CONCLUSIONS: -Native T1 maps at 3T can determine the location, size and transmurality of CMI with high diagnostic accuracy. Patient studies are necessary for clinical translation.
Authors:
Avinash Kali; Ivan Cokic; Richard L Q Tang; Hsin-Jung Yang; Behzad Sharif; Eduardo Marbán; Debiao Li; Daniel Berman; Rohan Dharmakumar
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-3-28
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  -     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2014 Mar 
Date Detail:
Created Date:  2014-3-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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