Comparison of magnetic resonance imaging studies with enzymatic indexes of myocardial necrosis for quantification of myocardial infarct size.
To evaluate the potential of gadolinium-diethylene triamine pentaacetic acid (DTPA)-enhanced magnetic resonance imaging (MRI) in the quantification of infarct size in patients with a first acute myocardial infarction, 24 patients with a first acute myocardial infarction were studied by electrocardiographic gated MRI at a mean of 4.3 days after the acute event. Multislice, single-phase, T1-weighted, spin-echo MRI in the true short-axis plane was performed 20 minutes after intravenous injection of gadolinium-DTPA (0.15 mmol/kg of body weight). Circumscript myocardial regions of increased signal intensity on gadolinium-DTPA-enhanced images were considered to be infarcted. Infarct size (in g) was determined using Simpson's rule, and was compared with that based on cumulative release of alpha-hydroxybutyrate dehydrogenase activity in plasma and with peak creatine kinase-MB level in plasma. Infarct size quantified with MRI correlated well with "enzymatic" infarct size (in g equivalents) (y = 0.99 x + 0.71; r = 0.93; p = 0.0001) and peak creatine kinase-MB levels (r = 0.72; p = 0.002). It is concluded that gadolinium-DTPA-enhanced MRI enables accurate quantification of infarct size in patients with a first acute myocardial infarction.
Holman
E R
ER
Department of Cardiology, University Hospital, Leiden, The Netherlands.
van Jonbergen
H P
HP
van Dijkman
P R
PR
van der Laarse
A
A
de Roos
A
A
van der Wall
E E
EE
D000328:Adult; D000368:Aged; D004796:Clinical Enzyme Tests; D003287:Contrast Media; D003402:Creatine Kinase / Q000032:analysis; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D006884:Hydroxybutyrate Dehydrogenase / Q000032:analysis; D007527:Isoenzymes; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000473:pathology; D009942:Organometallic Compounds; D004369:Pentetic Acid
D003287:Contrast Media; D007527:Isoenzymes; D009942:Organometallic Compounds; D004369:Pentetic Acid; C035749:2-hydroxybutyrate dehydrogenase; D006884:Hydroxybutyrate Dehydrogenase; D003402:Creatine Kinase; D019786:Gadolinium DTPA