title: Characterization of the peri-infarction zone using T2-weighted MRI and delayed-enhancement MRI in patients with acute myocardial infarction.
abstract: To characterize the peri-infarction zone using T2-weighted (T2w) magnetic resonance imaging (MRI) and infarct size on delayed enhancement (DE) MRI in patients with acute myocardial infarction (AMI). In 65 patients, short-axis T2w and DE MRI images were acquired 5 +/- 3 d after AMI. The MRI was analyzed using a threshold method defining infarct size on DE MRI and edema on T2w MRI as areas with signal intensity larger than +2 SD above remote normal myocardium. The peri-infarction zone was calculated as the difference between the size of edema and the infarct size. The size of edema on T2w MRI (31.3 +/- 13.4% of LV area) was larger than the infarct size on DE MRI (20.3 +/- 10.4% of LV area, p< 0.0001). The size of the peri-infarction zone was 11.0 +/- 10.0% of the LV area. Good correlation was found between infarct size on DE MRI and peak creatine kinase (CK) isoenzyme MB (r = 0.65, p< 0.0001), but there was no correlation between the size of the peri-infarction zone and CK MB (r = 0.05, p = 0.67). The peri-infarction zone was larger in patients with an infarct size <28% of the LV area (12.6 +/- 10.0% LV area) compared with patients with an infarct size > or =28% of the LV area (6.7 +/- 9.0% of the LV area, p< 0.05). The peri-infarction zone does not correlate with enzymatic parameters of infarct size and is substantially larger in small infarcts, indicating viable myocardium.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. astork@uke.uni-hamburg.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Stork
authors.forename: Gunnar K
authors.initials: GK
authors.lastname: Lund
authors.forename: Kai
authors.initials: K
authors.lastname: Muellerleile
authors.forename: Paul M
authors.initials: PM
authors.lastname: Bansmann
authors.forename: Claus
authors.initials: C
authors.lastname: Nolte-Ernsting
authors.forename: Joern
authors.initials: J
authors.lastname: Kemper
authors.forename: Philipp G C
authors.initials: PG
authors.lastname: Begemann
authors.forename: Gerhard
authors.initials: G
authors.lastname: Adam
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D004487:Edema / Q000175:diagnosis; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology*
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA