title: Cardiac MRI to investigate myocardial scar and coronary venous anatomy using a slow infusion of dimeglumine gadobenate in patients undergoing assessment for cardiac resynchronization therapy.
abstract: OBJECTIVE
  To evaluate a cardiac MR (CMR) examination with slow infusion of a high-relaxivity contrast agent to visualize coronary venous anatomy (CVA) and myocardial scar in heart failure patients awaiting cardiac resynchronization therapy (CRT).
  
  
  METHODS
  Fourteen patients awaiting CRT (seven ischemic cardiomyopathy (ICM) and seven non-ICM) and two with normal LV function underwent CMR on a 1.5 Tesla (T) MR scanner. Dimeglumine-gadobenate was slowly infused. Bolus arrival in the LV was measured by a dynamic electrocardiogram (ECG) -triggered inversion recovery (IR) scan subsequent to starting an ECG-triggered respiratory-navigated three-dimensional (3D) SSFP MR scan with IR preparation to acquire systolic whole-heart anatomy for vein visualization. Delayed contrast-enhanced MR scan was performed to assess myocardial scar. CVA obtained by CMR was compared with X-ray venography in 11 patients. CVA and scar were segmented and registered for visual inspection.
  
  
  RESULTS
  For all subjects, there was excellent visualization of the CVA. All ICM and one non-ICM patient showed scar. There was excellent correlation between veins seen by CMR and venography.
  
  
  CONCLUSIONS
  We have demonstrated that slow infusion protocol of dimeglumine-gadobenate can be used to assess both CVA and myocardial scar in a single MR examination. Furthermore, an image overlay technique has been used to show the relationship of scar to the CVA.
authors.affiliation: King's College London, BHF Centre, Division of Imaging Sciences, NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust, London, UK. simon.duckett@kcl.ac.uk
authors.forename: Simon G
authors.initials: SG
authors.lastname: Duckett
authors.forename: Amedeo
authors.initials: A
authors.lastname: Chiribiri
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Ginks
authors.forename: Stephen
authors.initials: S
authors.lastname: Sinclair
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Knowles
authors.forename: Rene
authors.initials: R
authors.lastname: Botnar
authors.forename: Gerry S
authors.initials: GS
authors.lastname: Carr-White
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Rinaldi
authors.forename: Eike
authors.initials: E
authors.lastname: Nagel
authors.forename: Reza
authors.initials: R
authors.lastname: Razavi
authors.forename: Tobias
authors.initials: T
authors.lastname: Schaeffter
mesh_terms: D058406:Cardiac Resynchronization Therapy; D009202:Cardiomyopathies / Q000473:pathology*; D002921:Cicatrix / Q000473:pathology*; D003287:Contrast Media / Q000008:administration & dosage; D003330:Coronary Vessel Anomalies / Q000473:pathology*; D003331:Coronary Vessels; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007262:Infusions, Intravenous; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014680:Veins / Q000002:abnormalities* / Q000473:pathology*
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA