[Magnetic resonance myocardial perfusion imaging for evaluating myocardial viability after myocardial infarction].
OBJECTIVE
To assess the value of magnetic resonance (MR) myocardial perfusion imaging (MRMPI) in evaluating the myocardial viability in patients with myocardial infarction.


METHODS
MRMPI was performed in 51 patients with myocardial infarction using a 1.5 T MR scanner. All the patients were examined using IR-turbo FLASH sequence during the first-pass and delayed phase 5-30 min after injection of 0.1 mmol/kg Gd-DTPA at the rate of 4 ml/s. The short axis images were acquired during the first-pass, and both the short axis and long axis images were obtained during the delayed phase. The left ventricular wall on the short-axis slice was divided into 8 segments. A correlative study of the results of the rest and stress (99m)Tc single photon emission computed tomography (SPECT) was carried out in 21 patients.


RESULTS
In the 51 patients with myocardial infarction, 42(82.3%) showed hypoperfusion during the first-pass imaging and 50(98%) had delayed hyperenhancement. In the 21 patients receiving SPECT, 48 nonviable segments was detected among the 168 segments scanned by (99m)TcSPECT, and MRMPI showed delayed hyperenhancement in all the infracted areas. Of the 120 viable segments detected by rest and stress (99m)Tc SPECT, 97 segments (80.8%) were found to be free of delayed hyperenhancement by MRMPI. With the rest and stress (99m)Tc SPECT as the reference, the sensitivity and the specificity of MRMPI were 100.0% and 80.8%, respectively.


CONCLUSIONS
MRMPI allows effective identification of the myocardial viability and nonviability as well as the severity and extent of the myocardial infraction.
Meng
Zhi-Hua
ZH
Depatment of Pathology, Southern Medical University, Guangzhou, China. zhihua_meng@163.com
Ding
Yan-Qing
YQ
Quan
Xian-Yue
XY
Xu
Xin
X
Tang
Liang-Qiou
LQ
Ma
Shao-Chun
SC
Pan
Gao-Sheng
GS
Lu
Yu-Ling
YL
Chen
Zhen-Shong
ZS
Lei
Shu-Fei
SF
Yang
Ang
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055414:Myocardial Perfusion Imaging / Q000379:methods; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon
D019786:Gadolinium DTPA