Multicompartmental analysis of late contrast enhancement in areas of myocardial infarction supplied by chronically occluded coronary arteries.
OBJECTIVE
To analyze the relationship between late contrast enhancement (LCE) and the interstitial distribution volume (V(In)) of gadolinium (Gd) tracers in the myocardial infarction (MI) areas supplied by chronically occluded arteries from patients. In animal experimental models, LCE has already been shown to correspond to an enhanced V(In) of Gd tracers and thus, to a decrease in the amount of intact cells.


METHODS
A multicompartmental analysis was applied to serial MRI images encompassing both infarct and remote areas and recorded with a conventional two-dimensional (2D) segmented inversion-recovery gradient-echo (IR-GRE) sequence during a 15-minute period following Gd-diethylenetriamine pentaacetic acid (Gd-DTPA) injection in 12 patients with Q-wave MI supplied by chronically occluded coronary arteries.


RESULTS
V(In) from infarct tissue was: 1) higher than V(In) from remote areas (in % of myocardial volume: 74 +/- 16% vs. 20 +/- 7%, P < 0.001); and 2) correlated with the quantification of LCE between infarct and noninfarct areas at the 15th minute (R(2) = 0.63, P = 0.002). However, the difference in V(In) between infarct and remote myocardium was a much better correlate of this quantified LCE (R(2) = 0.85, P < 0.001).


CONCLUSIONS
Detection of LCE in the MI territories supplied by chronically occluded arteries relates to the difference in the V(In) of tracers between the infarct and the noninfarct areas.
Mandry
Damien
D
INSERM, ERI13 Imagerie Adaptative Diagnostique et Interventionnelle, Nancy, France. d.mandry@chu-nancy.fr
Lapicque
Françoise
F
Odille
Freddy
F
Djaballah
Wassila
W
Codreanu
Andrei
A
Escanyé
Jean-Marie
JM
Felblinger
Jacques
J
Karcher
Gilles
G
Claudon
Michel
M
Marie
Pierre-Yves
PY
D000465:Algorithms; D002908:Chronic Disease; D003198:Computer Simulation; D003287:Contrast Media; D054059:Coronary Occlusion / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media; D019786:Gadolinium DTPA