Value of gadolinium-diethylene-triamine pentaacetic acid dynamics in magnetic resonance imaging of acute myocardial infarction with occluded and reperfused coronary arteries after thrombolysis.
The use of the paramagnetic contrast agent gadolinium-diethylene-triamine pentaacetic acid (DTPA) was evaluated in magnetic resonance imaging (MRI) of 18 patients with an acute myocardial infarction after thrombolysis. The patency of the infarct-related vessel was assessed by coronary angiography. At 58 +/- 9 hours after infarction MRI was performed before and after bolus injection of 0.1 mmol/kg gadolinium-DTPA. Myocardial signal intensities were measured using a circumferential profile. Normal and infarcted myocardium showed a maximum signal intensity enhancement of 35 and 66%, respectively. Signal intensity of infarcted relative to normal myocardium (I/N) increased from 1.06 +/- 0.16 before to a maximum of 1.39 +/- 0.13 after gadolinium-DTPA (p less than 0.001), whereas the contrast between normal myocardium and a pseudo-infarct region in 2 healthy volunteers did not change. Between patients with reperfused infarct-related vessels and occluded vessels without collaterals, maximum I/N did not differ. However, observing I/N as a function of time after injection of gadolinium-DTPA, the reperfusion group differed from the occlusion group on images acquired directly after injection (1.29 +/- 0.10 vs 1.14 +/- 0.05, p less than 0.02). Thus, gadolinium-DTPA enhanced the visualization of acute myocardial infarction on relatively longitudinal (T1)-weighted MR images and its dynamics seem of potential value for the noninvasive assessment of coronary artery reperfusion after thrombolysis.
Van Rossum
A C
AC
Department of Cardiology, Free University Hospital, Amsterdam, The Netherlands.
Visser
F C
FC
Van Eenige
M J
MJ
Sprenger
M
M
Valk
J
J
Verheugt
F W
FW
Roos
J P
JP
D000328:Adult; D003287:Contrast Media; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D019786:Gadolinium DTPA; D006339:Heart Rate; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008961:Models, Structural; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D015425:Myocardial Reperfusion; D009942:Organometallic Compounds; D004369:Pentetic Acid; D013300:Streptokinase / Q000627:therapeutic use
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D013300:Streptokinase; D019786:Gadolinium DTPA