Document Detail


Relation between signal intensity on T2-weighted MR images and presence of microvascular obstruction in patients with acute myocardial infarction.
MedLine Citation:
PMID:  19770302     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: In experimental animal models and human autopsy studies, hemorrhagic infarction caused by microvascular injury has been detected after coronary reperfusion. The purpose of this study was to determine whether detection of myocardial edema with T2-weighted MRI is influenced by the presence of microvascular obstruction. SUBJECTS AND METHODS: Thirty-seven patients underwent black-blood fat-suppressed T2-weighted, rest perfusion, and late gadolinium-enhanced MRI 5.4 +/- 3.1 days after the onset of acute myocardial infarction. On T2-weighted MR images, the signal intensity in relation to that of remote myocardium was determined in the late gadolinium-enhanced and periinfarction areas. Segment-based analysis was performed to determine whether the presence of microvascular obstruction influences the detection of myocardial edema. RESULTS: The averaged signal intensity in the late gadolinium-enhanced area without microvascular obstruction was significantly higher than the signal intensity in remote normal myocardium (relative signal intensity, 1.83 +/- 0.50; p < 0.001). In contrast, the signal intensity in the microvascular obstruction area on T2-weighted images was not significantly different from the signal intensity in remote myocardium (relative signal intensity, 1.14 +/- 0.26). The percentages of late gadolinium-enhanced segments with high signal intensity on T2-weighted MR images were 95% (73/77) without microvascular obstruction and 30% (22/73) with microvascular obstruction. CONCLUSION: With T2-weighted MRI, infarction-associated edema can be reliably detected in infarct lesions without microvascular obstruction. Microvascular obstruction, however, does not necessarily exhibit high signal intensity on T2-weighted MRI. Careful attention is required in interpretation of cardiac MR images of patients who have experienced acute myocardial infarction and undergone percutaneous coronary intervention. The findings on T2-weighted MR images can be substantial underestimates of the extent of acute myocardial infarction.
Authors:
Yoko Mikami; Hajime Sakuma; Motonori Nagata; Masaki Ishida; Tairo Kurita; Issei Komuro; Masaaki Ito
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  193     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-22     Completed Date:  2009-10-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  W321-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. yokomikami@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Coronary Vessels / pathology
Edema, Cardiac / complications*,  diagnosis*
Female
Humans
Magnetic Resonance Imaging / methods*
Male
Microvessels / pathology*
Middle Aged
Myocardial Infarction / complications*,  diagnosis*
Reproducibility of Results
Sensitivity and Specificity
Statistics as Topic

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


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