Abstract
To assess the signal pattern in T2-weighted images (T2WI) and determine its relation to persistent microvascular obstruction (PMO) and intramyocardial hemorrhage in a porcine model with reperfused acute myocardial infarction. Left anterior descending artery was occluded (90 or 180 min) and reperfused (90 min). T2WI and delayed-enhanced magnetic resonance images (DE-MRI) were acquired. The T2WI signal pattern, T2WI contrast ratio, PMO, and intramyocardial hemorrhage were evaluated, and their interrelationships were analyzed. The infarct area on T2WI was recorded as a homogeneous high-intensity signal or as low- or iso-intensity signals. The contrast ratio of the T2WI in the cases with PMO was significantly lower than that in those without PMO (1.38 ± 0.25 vs. 1.89 ± 0.31, P < 0.05), and it showed significant inverse correlation with the extent of PMO observed in DE-MRI images (r =−0.8, P < 0.05). The extent of PMO correlated strongly with that of intramyocardial hemorrhage (r = 0.97, P < 0.05). The abnormal signal area in the T2WI was larger than the infarct area in the DE-MRI images (47.0 ± 9.9% vs. 37.8 ± 9.9%, P < 0.05) and the infarct area observed after TTC staining (47.0 ± 9.9% vs. 37.4 ± 8.4%, P < 0.05). We observed variable T2WI signal patterns for the infarcted myocardium. Lower T2WI contrast ratios significantly correlated with the extent of PMO in DE-MRI and intramyocardial hemorrhage in the gross specimen.
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References
Lim TH, Choi SI (1999) MRI of myocardial infarction. J Magn Reson Imaging 10(5):686–693. doi:10.1002/(SICI)1522-2586(199911)10:5<686::AID-JMRI11>3.0.CO;2-H
Choi SI, Choi SH, Kim ST et al (2000) Irreversibly damaged myocardium at MR imaging with a necrotic tissue-specific contrast agent in a cat model. Radiology 215(3):863–868
Choi SI, Jiang CZ, Lim KH et al (2000) Application of breath-hold T2-weighted, first-pass perfusion and gadolinium-enhanced T1-weighted MR imaging for assessment of myocardial viability in a pig model. J Magn Reson Imaging 11(5):476–480. doi:10.1002/(SICI)1522-2586(200005)11:5<476::AID-JMRI2>3.0.CO;2-5
Jeong AK, Choi SI, Kim DH et al (2001) Evaluation by contrast-enhanced MR imaging of the lateral border zone in reperfused myocardial infarction in a cat model. Korean J Radiol 2(1):21–27
Choi SH, Lee SS, Choi SI et al (2001) Occlusive myocardial infarction: investigation of bis-gadolinium mesoporphyrins-enhanced T1-weighted MR imaging in a cat model. Radiology 220(2):436–440
Schmiedl U, Sievers RE, Brasch RC et al (1989) Acute myocardial ischemia and reperfusion: MR imaging with albumin-Gd-DTPA. Radiology 170(2):351–356
Kim RJ, Wu E, Rafael A et al (2000) The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med 343(20):1445–1453. doi:10.1056/NEJM200011163432003
Ito H, Tomooka T, Sakai N et al (1992) Lack of myocardial perfusion immediately after successful thrombolysis. A predictor of poor recovery of left ventricular function in anterior myocardial infarction. Circulation 85(5):1699–1705
Wu KC, Zerhouni EA, Judd RM et al (1998) Prognostic significance of microvascular obstruction by magnetic resonance imaging in patients with acute myocardial infarction. Circulation 97(8):765–772
Hombach V, Grebe O, Merkle N et al (2005) Sequelae of acute myocardial infarction regarding cardiac structure and function and their prognostic significance as assessed by magnetic resonance imaging. Eur Heart J 26(6):549–557. doi:10.1093/eurheartj/ehi147
Nijveldt R, Beek AM, Hirsch A et al (2008) Functional recovery after acute myocardial infarction: comparison between angiography, electrocardiography, and cardiovascular magnetic resonance measures of microvascular injury. J Am Coll Cardiol 52(3):181–189. doi:10.1016/j.jacc.2008.04.006
Lim TH, Hong MK, Lee JS et al (1997) Novel application of breath-hold turbo spin-echo T2 MRI for detection of acute myocardial infarction. J Magn Reson Imaging 7(6):996–1001. doi:10.1002/jmri.1880070611
Simonetti OP, Finn JP, White RD et al (1996) “Black blood” T2-weighted inversion-recovery MR imaging of the heart. Radiology 199(1):49–57
Higgins CB, Herfkens R, Lipton MJ et al (1983) Nuclear magnetic resonance imaging of acute myocardial infarction in dogs: alterations in magnetic relaxation times. Am J Cardiol 52(1):184–188. doi:10.1016/0002-9149(83)90093-0
Aletras AH, Tilak GS, Natanzon A et al (2006) Retrospective determination of the area at risk for reperfused acute myocardial iInfarction with T2-weighted cardiac magnetic resonance imaging: histopathological and displacement encoding with stimulated echoes (DENSE) functional validations. Circulation 113(15):1865–1870. doi:10.1161/CIRCULATIONAHA.105.576025
Jackowski C, Christe A, Sonnenschein M et al (2006) Postmortem unenhanced magnetic resonance imaging of myocardial infarction in correlation to histological infarction age characterization. Eur Heart J 27(20):2459–2467. doi:10.1093/eurheartj/ehl255
Stork A, Lund GK, Muellerleile K et al (2006) Characterization of the peri-infarction zone using T2-weighted MRI and delayed-enhancement MRI in patients with acute myocardial infarction. Eur Radiol 16(10):2350–2357. doi:10.1007/s00330-006-0232-3
van den Bos EJ, Baks T, Moelker AD et al (2006) Magnetic resonance imaging of haemorrhage within reperfused myocardial infarcts: possible interference with iron oxide-labelled cell tracking? Eur Heart J 27(13):1620–1626. doi:10.1093/eurheartj/ehl059
Reffelmann T, Kloner RA (2002) Microvascular reperfusion injury: rapid expansion of anatomic no reflow during reperfusion in the rabbit. Am J Physiol Heart Circ Physiol 283(3):H1099–H1107
Asanuma T, Tanabe K, Ochiai K et al (1997) Relationship between progressive microvascular damage and intramyocardial hemorrhage in patients with reperfused anterior myocardial infarction: myocardial contrast echocardiographic study. Circulation 96(2):448–453
McNamara MT, Higgins CB (1986) Magnetic resonance imaging of chronic myocardial infarcts in man. AJR Am J Roentgenol 146(2):315–320
Abdel-Aty H, Zagrosek A, Schulz-Menger J et al (2004) Delayed enhancement and T2-weighted cardiovascular magnetic resonance imaging differentiate acute from chronic myocardial infarction. Circulation 109(20):2411–2416. doi:10.1161/01.CIR.0000127428.10985.C6
Lund GK, Stork A, Saeed M et al (2004) Acute myocardial infarction: evaluation with first-pass enhancement and delayed enhancement MR imaging compared with 201TI SPECT imaging. Radiology 232(1):49–57. doi:10.1148/radiol.2321031127
Kuo PH, Kanal E, Abu-Alfa AK et al (2007) Gadolinium-based MR contrast agents and nephrogenic systemic fibrosis. Radiology 242(3):647–649. doi:10.1148/radiol.2423061640
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Choi, S.H., Kang, JW., Kim, ST. et al. Investigation of T2-weighted signal intensity of infarcted myocardium and its correlation with delayed enhancement magnetic resonance imaging in a porcine model with reperfused acute myocardial infarction. Int J Cardiovasc Imaging 25 (Suppl 1), 111–119 (2009). https://doi.org/10.1007/s10554-009-9425-6
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DOI: https://doi.org/10.1007/s10554-009-9425-6