Assessment of acute myocardial infarction in man with magnetic resonance imaging and the use of a new paramagnetic contrast agent gadolinium-BOPTA.
To assess the feasibility of and characterize the new paramagnetic contrast agent gadolinium-BOPTA/dimeglumine (Gd-BOPTA) to detect acute myocardial infarctions with MR imaging, 24 patients (53.3 +/- 8.3 yr) were examined 9.3 +/- 3.6 days after a first myocardial infarction. Short-axis T1-weighted and T2-weighted MR imaging was performed at three slice levels. T1-weighted images were obtained before, immediately after, 15, 30, and 45 min after injection. Patients received either 0.05 or 0.1 mmol/kg body weight Gd-BOPTA. Images were qualitatively and quantitatively analyzed. Two patients showed no signs of infarction on T2-weighted images as opposed to contrast-enhanced T1-weighted images. Contrast-to-noise ratio was not affected by the dosage level. Signal intensity (SI) of normal to infarcted myocardium was significantly improved by both dosages (p < .0005) but a dosage of 0.05 mmol/kg produced significantly higher SI inf/norm (1.42 +/- 0.07 vs. 1.34 +/- 0.06, respectively, p = .015). SI of normal and infarcted myocardium enhanced immediately after administration of 0.05 mmol/kg (29.3 +/- 5.1% and 53.8 +/- 9.6% respectively), which decreased thereafter to 5.3 +/- 4.8% and 40.2 +/- 8.5% respectively, at 45 min (p < .002 for normal myocardium). SI enhancement immediately after 0.1 mmol/kg Gd-BOPTA showed no decrease within the first 45 min. Gd-BOPTA enables the detection of myocardial infarction. Optimal infarct delineation is achieved from 15 to 45 min after administration of 0.05 mmol/kg body weight Gd-BOPTA. Gd-BOPTA at 0.05 mmol/kg does improve image quality as measured by contrast-to-noise ratio and SI enhancement as compared to 0.10 mmol/kg.
Holman
E R
ER
Department of Cardiology, University Hospital, Leiden, The Netherlands.
van Rossum
A C
AC
Doesburg
T
T
van der Wall
E E
EE
de Roos
A
A
Visser
C A
CA
D000328:Adult; D000368:Aged; D003287:Contrast Media; D005682:Gadolinium; D006321:Heart / Q000033:anatomy & histology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D009206:Myocardium / Q000473:pathology; D009942:Organometallic Compounds
D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; D005682:Gadolinium