(Circulation. 1999;99:690-696.)
© 1999 American Heart Association, Inc.
Basic Science Reports |
Noninvasive Measurements of Infarct Size After Thrombolysis With a Necrosis-Avid MRI Contrast Agent
From the Departments of Cardiology (S.V.P., C.P., F.J.v.d.W.) and Radiology (Y.N., H.B., Y.M., J.B., S.D., G.M.), University Hospitals Leuven, Belgium, and the Institut für Diagnostikforschung an der Freien Universität Berlin, Germany (W.S.).
Correspondence to Frans J. Van de Werf, MD, PhD, Department of Cardiology, UZ Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. E-mail frans.vandewerf{at}uz.kuleuven.ac.be
Background—Gadophrin-2 is a new MRI contrast agent with high affinity for necrotic myocardium. The aim of the study was to evaluate whether noninvasive measurements of infarct size after thrombolysis are possible with gadophrin-2–enhanced MRI.
Methods and Results—Coronary artery thrombosis was induced in 3 groups of dogs by the copper-coil technique. Thrombolytic therapy together with aspirin and heparin was initiated after 90 minutes of occlusion. One day (group A), 2 days (group B), or 6 days (group C) after infarction, gadophrin-2 was injected intravenously (50 µmol · kg-1). In vivo T1-weighted segmented turbo-FLASH, in vivo T2-weighted segmented half-Fourier turbo spin echo (HASTE), and T1- and T2-weighted spin-echo MRI of the excised heart were performed 24 hours after gadophrin-2 injection. Regions of strong enhancement were observed on T1-weighted images. Planimetry of short-axis MR images and of corresponding triphenyltetrazolium chloride (TTC)-stained left ventricular (LV) slices showed a close correlation between the enhanced areas and TTC-negative areas for both in vivo (r2=0.98, P<0.0001; mean difference, 0.9±2.0% [SD] of the LV volume [LVV]) and postmortem (r2=0.99, P<0.0001; mean difference, 0.9±1.4% of LVV) measurements. T2-weighted images overestimated the infarct size by 8.1±5.4% of LVV. The mean infarct size was 10.8±11.6% of LVV (group A), 22.4±11.7% (group B), and 5.1±9.3% (group C).
Conclusions—In this animal model, in vivo gadophrin-2–enhanced MRI could precisely determine infarct size after thrombolytic therapy. This technique may be very useful for the noninvasive evaluation of infarct size after reperfusion for AMI.
Key Words: magnetic resonance imaging • myocardial infarction • thrombolysis • diagnosis
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