title: Assessment of the acute effects of glucocorticoid treatment on coronary microembolization using cine, first-pass perfusion, and delayed enhancement MRI.
abstract: OBJECTIVE
  To assess the acute effects of methylprednisone treatment (MPT) on coronary microembolization (CME) by cardiac cine, first-pass perfusion, and delayed gadolinium enhancement magnetic resonance imaging (DE-MRI) in an experimental swine model.
  
  
  METHODS
  Microembolization was established by intracoronary infusion of microspheres into the left anterior artery. Swine received placebo (n = 12) or methylprednisolone (n = 10, 30 mg/kg) intravenously 30 minutes before microembolization. Perfusion and DE-MRI was performed 6 hours after microembolization. Cine MR images of pre-/post-CME were obtained using 1.5T scanner.
  
  
  RESULTS
  Cine MRI demonstrated relative amelioration of the post-CME myocardial contractile dysfunction in the glucocorticoid-treated group compared to the placebo group (P < 0.001). Post-CME target myocardial perfusion parameters decreased in both groups after microembolization. The extent of these decreases were the same for the embolized-to-control area ratio of maximum upslope (P = 0.245; 95% confidence interval of the difference [CID], -0.041/0.148) and time to peak ratio (P = 0.122; 95% CID, -0.201/0.026); however, the maximum signal intensity was higher in the glucocorticoid-treated group (P = 0.012; 95% CID, 0.023/0.156). DE-MRI revealed patchy hyperenhancement in all placebo pigs (n = 12/12) after microembolization, but no hyperenhanced regions in the glucocorticoid-pretreated pigs (n = 0/10).
  
  
  CONCLUSIONS
  Standard, readily available, cardiac MRI techniques are useful in demonstrating post-CME myocardial dysfunction and the acute effects of glucocorticoid treatment on CME. Glucocorticoid pretreatment improves myocardial contractile dysfunction, prevents hyperenhancement, and partially ameliorates the decline of myocardial perfusion in the embolized area.
authors.affiliation: Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China.|Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Hang
authors.initials: H
authors.lastname: Jin
authors.affiliation: Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China.|Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yun
authors.affiliation: Department of Cardiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
authors.forename: Jian-ying
authors.initials: JY
authors.lastname: Ma
authors.affiliation: Department of Cardiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
authors.forename: Zhang-wei
authors.initials: ZW
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
authors.forename: Shu-fu
authors.initials: SF
authors.lastname: Chang
authors.affiliation: Department of Radiology, the 5th people's Hospital of Shanghai, Fudan University, Shanghai, China.
authors.forename: Mei-ying
authors.initials: MY
authors.lastname: Ge
authors.affiliation: Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China.|Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Meng-su
authors.initials: MS
authors.lastname: Zeng
mesh_terms: D000818:Animals; D003331:Coronary Vessels / Q000473:pathology; D004195:Disease Models, Animal; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology*; D006321:Heart / Q000187:drug effects; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008775:Methylprednisolone / Q000494:pharmacology; D008863:Microspheres; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D010477:Perfusion; D013552:Swine
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone
keywords: cardiac MRI; contractile dysfunction; coronary microembolization; delayed contrast enhancement; inflammation; myocardial perfusion