title: Diagnostic value of late gadolinium-enhanced MRI and first-pass dynamic MRI for predicting functional recovery in patients after acute myocardial infarction.
abstract: OBJECTIVE
  The aim of this study was to determine the comparative diagnostic values of late gadolinium-enhanced magnetic resonance imaging (MRI) and first-pass dynamic MRI for predicting functional recovery of regional myocardial contraction in patients early after acute myocardial infarction.
  
  
  METHODS
  First-pass and late-enhanced MRI were performed in 18 patients 5.5 +/- 2.5 days after the onset of myocardial infarction. Images analysis was performed using a 12-segment model. Regional systolic wall thickening (SWT) was measured on cine-MRI obtained 273 +/- 130 days later.
  
  
  RESULTS
  Late-enhanced MRI revealed hyperenhancement in all patients, whereas hypoenhancement on first-pass MRI was observed in 67% (12/18) of the patients. The area under the receiver operating characteristics curve was 0.86 for late-enhanced MRI and 0.74 for first-pass MRI (P = 0.27). First-pass MRI was useful for predicting functional recovery of the segments that showed hyperenhancement of >50% of tissue on late-enhanced MRI. In these segments, preserved SWT was observed in 15 of 33 segments (45%) with first-pass hypoenhancement of < or =50% of tissue, but in only 2 of 22 segments (9%) with first-pass hypoenhancement of >50% of tissue.
  
  
  CONCLUSIONS
  Whereas the diagnostic capability of first-pass MRI alone is limited, complementary use of first-pass MRI can enhance the diagnostic performance of late-enhanced MRI because hypoenhancement during first-pass imaging is more specific to nonviable myocardium.
authors.affiliation: Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, 514-8507, Japan. kakuya@clin.medic.mie-u.ac.jp
authors.forename: Kakuya
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Ichikawa
authors.forename: Tadanori
authors.initials: T
authors.lastname: Hirano
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Makino
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Kan
authors.initials: K
authors.lastname: Takeda
authors.forename: Hajime
authors.initials: H
authors.lastname: Sakuma
mesh_terms: D005260:Female; D005682:Gadolinium; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology*
chemical_list: D005682:Gadolinium