Alterations in T1 of normal and reperfused infarcted myocardium after Gd-BOPTA versus GD-DTPA on inversion recovery EPI

This study tested whether Gd-BOPTA/Dimeg or Gd-DTPA exerts greater relaxation enhancement for blood and reperfused infarcted myocardium. Relaxivity of Gd-BOPTA is increased by weak binding to serum albumin. Thirty-six rats were subjected to reperfused infarction before contrast (doses = 0.05, 0.1, and 0.2 mmol/kg). ΔR1 was repeatedly measured over 30 min. Gd-BOPTA caused greater ΔR1 for blood and myocardium than did Gd-DTPA clearance of both agents from normal and infarcted myocardium was similar to blood clearance; plots of ΔR1myocardium/ΔR1blood showed equilibrium phase contrast distribution. Fractional contrast agent distribution volumes were approximately 0.24 for both agents in normal myocardium, 0.98 and 1.6 for Gd-DTPA and Gd-BOPTA, respectively, in reperfused infarction. The high value for Gd-BOPTA was ascribed to greater relaxivity in infarction versus blood. It was concluded that Gd-BOPTA/Dimeg causes a greater ΔR1 than Gd-DTPA in regions which contain serum albumin.     

Comparison of intravascular and extracellular contrast media for absolute quantification of myocardial rest-perfusion using high-resolution MRI

Purpose:

To use the contrast agent gadofosveset for absolute quantification of myocardial perfusion and compare it with gadobenate dimeglumine (Gd‐BOPTA) using a high‐resolution generalized autocalibrating partially parallel acquisition (GRAPPA) sequence.

Materials and Methods:

Ten healthy volunteers were examined twice at two different dates with a first‐pass perfusion examination at rest using prebolus technique. We used a 1.5 T scanner and a 32 channel heart‐array coil with a steady‐state free precession (SSFP) true fast imaging with steady state precession (trueFISP) GRAPPA sequence (acceleration‐factor 3). Manual delineation of the myocardial contours was performed and absolute quantification was performed after baseline and contamination correction. At the first appointment, 1cc/4cc of the extracellular contrast agent Gd‐BOPTA were administered, on the second date, 1cc/4cc of the blood pool contrast agent (CA) gadofosveset. At each date the examination was repeated after a 15‐minute time interval.

Results:

Using gadofosveset perfusion the value (in cc/g/min) at rest was 0.66 ± 0.25 (mean ± standard deviation) for the first, and 0.55 ± 0.24 for the second CA application; for Gd‐BOPTA it was 0.62 ± 0.25 and 0.45 ± 0.23. No significant difference was found between the acquired perfusion values. The apparent mean residence time in the myocardium was 23 seconds for gadofosveset and 19.5 seconds for Gd‐BOPTA. Neither signal‐to‐noise ratio (SNR) nor subjectively rated image contrast showed a significant difference.

Conclusion:

The application of gadofosveset for an absolute quantification of myocardial perfusion is possible. Yet the acquired perfusion values show no significant differences to those determined with Gd‐BOPTA, maintained the same SNR and comparable perfusion values, and did not picture the expected concentration time‐course for an intravasal CA in the first pass. J. Magn. Reson. Imaging 2011;33:1047–1051. © 2011 Wiley‐Liss, Inc.     

Relationship between contrast enhancement on fluid-attenuated inversion recovery MR sequences and signal intensity on T2-weighted MR images: visual evaluation of brain tumors

PURPOSE: To investigate the relationship between the degree of contrast enhancement in fluid-attenuated inversion recovery (FLAIR) sequences and tumor signal intensity on T2-weighted images. MATERIALS AND METHODS: A total of 96 patients suspected of having brain tumors were examined by MR imaging, and whenever a brain tumor with an enhancing part larger than the slice thickness was demonstrated on postcontrast T1-weighted images, postcontrast FLAIR images were additionally acquired. The tumor signal intensity on the T2-weighted images was visually classified as follows: equal or lower compared with normal cerebral cortex (group 1), higher than normal cortex (group 2), and as high as cerebrospinal fluid (CSF) (group 3). When a lesion contained several parts with different signal intensities on T2-weighted images, we assessed each part separately. In each group, we visually compared pre- and postcontrast FLAIR images and assessed whether tumor contrast enhancement was present. When contrast enhancement was present on FLAIR sequence, the degree of contrast enhancement in T1-weighted and FLAIR sequences was visually compared. RESULTS: Postcontrast T1-weighted images showed 46 enhancing lesions, including 48 parts, in 31 MR examinations. FLAIR images of the lesion-parts in group 1 (N=18) did not show significant contrast enhancement. In group 2 (N=12), all the parts were enhanced in FLAIR sequences, and three parts were enhanced more clearly in the FLAIR sequences than in the T1-weighted sequences. In group 3 (N=18), all the parts were enhanced equally or more clearly in the FLAIR sequences than in the T1-weighted sequences. CONCLUSION: The signal intensity in FLAIR sequences is largely influenced by both T1 and T2 relaxation time; there is a close relationship between the signal intensity of brain tumors on T2-weighted images and the degree of contrast enhancement on FLAIR sequences. When tumors have higher signal intensity than normal cortex on T2-weighted images, additional postcontrast FLAIR imaging may improve their depiction.     

Absolute blood contrast concentration and blood signal saturation on myocardial perfusion MRI: Estimation from CT data

Purpose

To determine the optimal contrast injection rate and absolute blood gadolinium concentration for optimal first‐pass imaging.

Materials and Methods

The concentration of contrast medium in left ventricle (LV) was estimated from dynamic computed tomography (CT) by administering iodinated contrast medium of volume (0.2 mL/kg) equivalent to 0.1 mmol/kg of gadolinium injection in 50 subjects. A blood sample study was performed to determine the relationship between blood signal and gadolinium concentration on perfusion MRI.

Results

The mean peak gadolinium concentration in LV increased as the injection rate increased from 1 mL/sec (3.7 ± 1.2 mM), to 4 mL/sec (6.9 ± 2.7 mM) (P < 0.01). However, no significant improvement was found with an increase in the injection rate from 4 mL/sec to 5 mL/sec (6.8 ± 1.5 mM, P = 0.86). In a blood sample study the linear relationship between blood signal and gadolinium concentration was maintained in the range of ≤0.67 mM (r = 0.992), which corresponds to a peak blood concentration following a 0.01 mmol/kg gadolinium injection.

Conclusion

The optimal contrast injection rate for myocardial perfusion magnetic resonance imaging (MRI) appears to be 4 mL/sec. Saturation of arterial input signal is inevitable if the dose of gadolinium contrast medium exceeds 0.01 mmol/kg. These findings are essential for accurate quantification of myocardial blood flow from perfusion MRI. J. Magn. Reson. Imaging 2009;29:205–210. © 2008 Wiley‐Liss, Inc.     

Echo planar MR imaging of the liver: comparison of images with and without motion probing gradients

PURPOSE: To determine whether MR images with motion-probing gradients (MPGs) usefully improve lesion detection in comparison with MR images without MPGs. MATERIALS AND METHODS: Echo planar (EP) images without MPGs and with small and intermediate MPGs (gradient factor b = 2, 18, and 188 second/mm(2), respectively) were acquired for 61 hepatic lesions (21 hepatocellular carcinomas (HCCs), 19 metastases, eight hemangiomas, and 13 cysts). The lesion-to-liver signal intensity ratios (SIRs) of these lesions were calculated using EP images with and without MPGs. Qualitative analysis for detection of HCCs and metastases were also performed between the images without MPGs and with small MPGs. RESULTS: The SIRs of HCCs and metastases for the images with small MPGs were significantly higher than the values for the images without MPGs (P < 0.05), although no significant differences were found in the case of hemangiomas and cysts. In comparison to images without MPGs, images with small MPGs improved lesion detection of three metastases and six HCCs, and worsened lesion detection of two HCCs. CONCLUSION: Images with small MPGs may improve HCC and metastasis detection over images without MPGs.     

大鼠原位肝癌纤维间质成分与MR延迟强化的关系

目的：探究大鼠原位肝癌纤维间质成分的特点及其与 MR延迟强化的关系。方法4只 Wistar大鼠原位肝癌模型行肝脏 MR扫描及多期延迟增强扫描,取12个肝癌标本行 HE、苦味酸-天狼猩红染色、Verhoeff Van-Gieson染色、Gordon-Sweets 染色及α-SMA免疫组化染色,观察肿瘤内及周边纤维间质特点及 MR延迟强化特点。结果肝细胞癌内胶原纤维分布于病灶内的纤维间隔中;弹力纤维分布于肿瘤内的纤维间隔及动脉血管壁;网状纤维分布于癌灶内、汇管区及假包膜纤维组织中。胶原、弹力、网状纤维的平均面密度值分别为0.102±0.020、0.063±0.018、0.109±0.032,胶原纤维及网状纤维与弹力纤维间有统计学差异(P<0.01),胶原纤维与 MR延迟强化间正相关(P<0.05)。结论大鼠肝癌 MR延迟强化与病灶内胶原纤维关系密切,MR 可对肝癌内胶原纤维进行无创评估。     

Scarred myocardium imposes additional burden on remote viable myocardium despite a reduction in the extent of area with late contrast MR enhancement

Magnetic resonance imaging (MRI) can simultaneously detect and quantify myocardial dysfunction and shrinkage in contrast-enhanced areas postinfarction. This ability permits the investigation of our hypothesis that transformation of infracted myocardium to scarred tissue imposes additional burdens on peri-infarcted and remote myocardium. Pigs (n=8) were subjected to reperfused infarction. Gd-DOTA-enhanced inversion recovery gradient echo sequence (IR-GRE) imaging was performed 3 days and 8 weeks postinfarction. Global and regional left ventricular (LV) function was evaluated by cine MRI. Triphenyltetrazolium chloride (TTC) stain was used to delineate infarction while hematoxylin and eosin (H & E) and Masson’s trichrome stains were used to characterize remodeled myocardium. Late contrast-enhanced MRIs showed a decrease in the extent of enhanced areas from 17±2% at 3 days to13±1% LV mass at 8 weeks. TTC infarction size was 12±1% LV mass. Cine MRIs showed expansion in dysfunctional area due to unfavorable remodeling, ischemia, or strain. Ejection fraction was reduced in association with increased end-diastolic and end-systolic volumes. Scarred myocardium contained collagen fibers and remodeled thick-walled vessels embedded in collagen. Sequential MRI showed greater LV dysfunction despite the shrinkage in extent of enhanced areas 2 months postinfarction. The integration of late enhancement and cine MRI incorporates anatomical and functional evaluation of remodeled hearts.This study was supported by grants from NIH (RO1HL07295) to Dr. Saeed     

Quantification of myocardial blood flow using model based analysis of first‐pass perfusion MRI: Extraction fraction of Gd‐DTPA varies with myocardial blood flow in human myocardium

For the absolute quantification of myocardial blood flow (MBF), Patlak plot‐derived K1 need to be converted to MBF by using the relation between the extraction fraction of gadolinium contrast agent and MBF. This study was conducted to determine the relation between extraction fraction of Gd‐DTPA and MBF in human heart at rest and during stress. Thirty‐four patients (19 men, mean age of 66.5 ± 11.0 years) with normal coronary arteries and no myocardial infarction were retrospectively evaluated. First‐pass myocardial perfusion MRI during adenosine triphosphate stress and at rest was performed using a dual bolus approach to correct for saturation of the blood signal. Myocardial K1 was quantified by Patlak plot method. Mean MBF was determined from coronary sinus flow measured by phase contrast cine MRI and left ventricle mass measured by cine MRI. The extraction fraction of Gd‐DTPA was calculated as the K1 divided by the mean MBF. The extraction fraction of Gd‐DTPA was 0.46 ± 0.22 at rest and 0.32 ± 0.13 during stress (P < 0.001). The relationship between extraction fraction (E) and MBF in human myocardium can be approximated as E = 1 ? exp(?(0.14 × MBF + 0.56)/MBF). The current results indicate that MBF can be accurately quantified by Patlak plot method of first‐pass myocardial perfusion MRI by performing a correction of extraction fraction. Magn Reson Med, 2011. © 2011 Wiley Periodicals, Inc.     

High‐resolution longitudinal assessment of flow and permeability in mouse glioma vasculature: Sequential small molecule and SPIO dynamic contrast agent MRI

The poor prognosis associated with malignant glioma is largely attributable to its invasiveness and robust angiogenesis. Angiogenesis involves host–tumor interaction and requires in vivo evaluation. Despite their versatility, few studies have used mouse glioma models with perfusion MRI approaches, and generally lack longitudinal study design. Using a micro‐MRI system (8.5 Tesla), a novel dual bolus‐tracking perfusion MRI strategy was implemented. Using the small molecule contrast agent Magnevist, dynamic contrast enhanced MRI was implemented in the intracranial 4C8 mouse glioma model to determine K^trans and v_e, indices of tumor vascular permeability and cellularity, respectively. Dynamic susceptibility contrast MRI was subsequently implemented to assess both cerebral blood flow and volume, using the macromolecular superparamagnetic iron oxide, Feridex, which circumvented tumor bolus susceptibility curve distortions from first‐pass extravasation. The high‐resolution parametric maps obtained over 4 weeks, indicated a progression of tumor vascularization, permeability, and decreased cellularity with tumor growth. In conclusion, a comprehensive array of key parameters were reliably quantified in a longitudinal mouse glioma study. The syngeneic 4C8 intracerebral mouse tumor model has excellent characteristics for studies of glioma angiogenesis. This approach provides a useful platform for noninvasive and highly diagnostic longitudinal investigations of anti‐angiogenesis strategies in a relevant orthotopic animal model. Magn Reson Med 61:615–625, 2009. © 2009 Wiley‐Liss, Inc.     

Magnetization exchange in capillaries by microcirculation affects diffusion-controlled spin-relaxation: A model which describes the effect of perfusion on relaxation enhancement by intravascular contrast agents

The effect of perfusion on relaxation time in tissue has only been considered for first-pass kinetics of NMR-signal after application of contrast agents. The importance of perfusion on relaxation has not yet been studied for steady state conditions, i.e., when the intravascular relaxation rate is constant in time. The aim of this study is to develop a model in which T, relaxation is derived as a function of perfusion and intracap-illary volume fraction (regional blood volume). Tissue is considered to be two-compartment system, which consists of intracapillary and extravascular space. Intracapillary relaxation differs from relaxation in the arterial system due to diffusion-exchange of magnetization from extravascular to intracapillary space. Perfusion tends to attenuate this difference and thus counteracts the effect on intracapillary relaxation. Relaxation in the extravascular space becomes a function of perfusion because extravascular and intracapillary magnetization are linked by diffusion. This dependence is presented in analytical form and a generic equation is derived. A T₁ experiment is considered in which all spins of tissue and blood are inverted at the beginning. Calculations are performed for the fast exchange model of tissue. Perfusion increases relaxation enhancement of intravascular contrast agents. This effect is considerable in highly perfused tissue like myocardium. The dependence of relaxation on perfusion implies an overestimation of the regional blood volume when the calculation of the latter is based on tissue models that neglect perfusion. The model presented here is applied to predict the effect of perfusion on T₁ imaging with FLASH-pulse sequences because this technique has been proven to be a powerful method to obtain T₁ maps within a short time interval. For the fast exchange model, two algorithms are suggested that determine perfusion and regional blood volume from T₁ imaging in the presence and absence of intravascular contrast agents.     

Quantification of renal perfusion using an intravascular contrast agent (part 1): results in a canine model.

In this work absolute values of regional renal blood volume (rRBV) and flow (rRBF) are assessed by means of contrast-enhanced (CE) MRI using an intravascular superparamagnetic contrast agent. In an animal study, eight foxhounds underwent dynamic susceptibility-weighted MRI upon injection of contrast agent. Using principles of indicator dilution theory and deconvolution analysis, parametric images of rRBV, rRBF, and mean transit time (MTT) were computed. For comparison, whole-organ blood flow was determined invasively by means of an implanted flow probe, and the weight of the kidneys was evaluated postmortem. A mean rBV value of 28 ml/100 g was found in the renal cortex, with a corresponding mean rBF value of 524 ml/100 g/min and an average MTT of about 3.4 s. Although there was a systematic difference between the absolute blood flow values determined by MRI and the ultrasonic probe, a significant correlation (r(s) = 0.72, P < 0.05) was established. The influence of the arterial input function (AIF), T(1) relaxation effects, and repeated measurements on the precision of the perfusion quantitation is discussed.     

Determination of the venous output function from MR signal phase: Feasibility for quantitative DCE‐MRI in human brain

For dynamic contrast‐enhanced MRI studies in the human brain, it is useful to measure the venous output function (VOF). The purpose of this work was to explore the feasibility of measuring the VOF using the MR signal phase (in absolute units of gadolinium concentration) in the superior sagittal sinus. Phantom experiments were performed to validate the technique for different superior sagittal sinus angles (θ = 0–48° relative to the main magnetic field), different curvatures (straight or radius = 45 mm), and different spatial resolutions (2.2–5.5 mm, to study partial‐volume effects). Additionally, the technique was tested on three patients. The phantom experimental results (echo time = 5.5 ms, θ ≤ 21°) agreed with theoretical predictions to within 10%. For the patient studies, the measured VOFs had reasonable amplitude and shape characteristics and the patients' superior sagittal sinus angles (<15°) and curvatures (radii ≈ 40 mm) were within the range explored with phantoms. Our results suggest that partial‐volume contributions to the VOF will be <5% and that the VOF can be evaluated in vivo to within 10% error. In conclusion, it is highly feasible to use MR signal phase to measure the VOF in the superior sagittal sinus for human dynamic contrast‐enhanced MRI. Magn Reson Med 63:772–781, 2010. © 2010 Wiley‐Liss, Inc.     

High resolution measurement of cerebral blood flow using intravascular tracer bolus passages. Part II: Experimental comparison and preliminary results

This report evaluates several methods to map relative cerebral blood flow (rCBF) by applying both parametric and non-parametric techniques to deconvolve high resolution dynamic MRI measurements of paramagnetic bolus passages with noninvasively determined arterial inputs. We found a nonparametric (singular value decomposition (SVD)) deconvolution technique produced the most robust results, giving mean gray:white flow ratio of 2.7 ± 0.5 (SEM) in six normal volunteers, in excellent agreement with recent PET literature values for age-matched subjects. Similar results were obtained by using a model-dependent approach that assumes an exponential residue function, but not for a Gaussian-shaped residue function or for either Fourier or regularization-based model-independent approaches. Pilot studies of our CBF mapping techniques in patients with tumor, stroke, and migraine aura demonstrated that these techniques can be readily used on data routinely acquired by using current echo planar imaging technology. By using these techniques, the authors visualized important regional hemodynamic changes not detectable with rCBV mapping algorithms.     

High resolution measurement of cerebral blood flow using intravascular tracer bolus passages. Part I: Mathematical approach and statistical analysis

The authors review the theoretical basis of determination of cerebral blood flow (CBF) using dynamic measurements of nondiffusible contrast agents, and demonstrate how parametric and nonparametric deconvolution techniques can be modified for the special requirements of CBF determination using dynamic MRI. Using Monte Carlo modeling, the use of simple, analytical residue models is shown to introduce large errors in flow estimates when actual, underlying vascular characteristics are not sufficiently described by the chosen function. The determination of the shape of the residue function on a regional basis is shown to be possible only at high signal-to-noise ratio. Comparison of several nonparametric deconvolution techniques showed that a nonparametric deconvolution technique (singular value decomposition) allows estimation of flow relatively independent of underlying vascular structure and volume even at low signal-to-noise ratio associated with pixel-by-pixel deconvolution.     

T1-relaxation kinetics of extracellular, intracellular and intravascular MR contrast agents in normal and acutely reperfused infarcted myocardium using echo-planar MR imaging

The objective of this study was to determine and compare if MR contrast agents distributed into various compartments can provide estimation of fractional distribution volume (FDV) in normal and infarcted myocardium using inversion recovery echo-planar MR imaging (IR EPI). Three different types of MR agents were investigated: (a) an extracellular agent, GdDTPA-BMA (0.1 mmol/kg); (b) an intravascular agent, GdDTPA-albumin (0.025 mmol/kg); and (c) an intracellular agent, manganese chloride (0.025 mmol/kg). The null point was determined from a series of IR EPI images in which TI was varied. Temporal changes in ΔR1 (ΔR1 = 1/T1_post-1/T1_pre) were measured during the initial 29–59 min after administration. Rats (n = 24) were subjected to 1-h coronary artery occlusion/reperfusion. Histochemical staining confirmed the presence and location of infarction. GdDTPA-BMA caused increase in ΔR1 of infarction < blood < < normal myocardium. ΔR1 ratios were 1.55 ± 0.08 for infarction and 0.33 ± 0.03 for normal myocardium, consistent with FDV of 0.82 ± 0.04 and 0.18 ± 0.01. The fractional distribution of this agent in normal myocardium approximated the extracellular space of myocardium. GdDTPA-albumin caused increase in ΔR1 of blood < < infarction < < normal myocardium. ΔR1 ratio in normal, but not infarcted, myocardium was constant at 0.10 ± 0.02 and approximated fractional blood volume. MnCl₂ caused equivalent increase in ΔR1 of normal and infarcted myocardium. ΔR1 of normal myocardium did not change overtime, whereas ΔR1 of blood rapidly decreased, leading to overestimation of FDV in normal and infarcted myocardium. In conclusion, extracellular, intravascular and intracellular MR contrast agents exhibited different T1-relaxation kinetics in both normal and infarcted myocardium. Constant ΔR1 ratio (myocardium/blood) after administration of MR contrast agent is a prerequisite for estimation of FDV of MR contrast agent in myocardium. Received: 22 December 1998; Revised: 7 April 1999; Accepted: 18 May 1999     

Active Crohn's disease in the small bowel: evaluation by diffusion weighted imaging and quantitative dynamic contrast enhanced MR imaging

Purpose

To determine relative diagnostic value of MR diffusion and perfusion parameters in detection of active small bowel inflammation in patients with Crohn's disease (CD).

Materials and Methods

We reviewed 18 patients with active CD of terminal ileum (TI) who underwent MR enterography (MRE; including dynamic contrast enhanced MRI and diffusion‐weighted MRI). Conventional MRI findings of TI were recorded. Regions of interest were drawn over TI and normal ileum to calculate apparent diffusion coefficient (ADC), the volume transfer constant (K^trans) and the contrast media distribution volume (v_e). Receiver operating characteristic analysis was used to determine their diagnostic performance.

Results

Among conventional MR findings, mural thickening and increased enhancement were present in all actively inflamed small bowel. K^trans, v_e, and ADC values differed significantly between actively inflamed TI and normal ileum (0.92 s^?1 versus 0.36 s^?1; 0.31 versus 0.15 ± 0.08; 0.00198 mm²/s versus 0.00311 mm²/s; P < 0.001). Area under the curve (AUC) for K^trans, v_e, and ADC values ranged from 0.88 to 0.92 for detection of active inflammation. Combining K^trans and ADC data provided an AUC value of 0.95.

Conclusion

Dynamic contrast‐enhanced MRI (DCE‐MRI) and diffusion‐weighted imaging (DWI) provide quantitative measures of small bowel inflammation that can differentiate actively inflamed small bowel segments from normal small bowel in CD. DWI provides better sensitivity compared with DCE‐MRI and combination of ADC and K^trans parameters for analysis can potentially improve specificity. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.

     

Wash-in rate on the basis of dynamic contrast-enhanced MRI: usefulness for prostate cancer detection and localization

PURPOSE: To evaluate the usefulness of the wash-in rate based on dynamic contrast-enhanced (DCE) MRI for the detection and localization of prostate cancer. MATERIALS AND METHODS: In 53 patients, the wash-in rate was measured in the cancer area and in three normal areas (the peripheral zone, inner portion of the transitional zone, and outer portion of the transitional zone). On the basis of these data, parametric imaging was generated and then its accuracy for cancer detection and location was evaluated compared to that of T2-weighted imaging without the use of an endorectal coil. For that purpose the entire prostate was divided into 18 segments. RESULTS: The wash-in rate value was greater in cancer tissue (9.2/second) than in three normal tissues (3.3/second, 6.7/second, and 3.2/second, respectively; P<0.001). The sensitivity and specificity were greater on parametric imaging of the wash-in rate compared to T2-weighted imaging in the entire prostate (96% and 82% vs. 65% and 60%, respectively) and the peripheral zone (96% and 97% vs. 75% and 53%; P<0.05). In the transitional zone, the sensitivity was greater on parametric imaging (96%) than on T2-weighted imaging (45%; P=0.016), but the specificity was similar (51% vs. 73%; P=0.102). CONCLUSION: The wash-in rate based on DCE-MRI is a useful parameter for prostate cancer detection and localization.     

Time course of contrast enhancement patterns after Gd-BOPTA in correlation to myocardial infarction and viability: a feasibility study.

Our objective was to analyze contrast enhancement patterns (CEP) and their time course after myocardial infarction (MI) following injection of Gd-BOPTA in correlation with recovery of regional function. Seven patients with subacute MI (18 +/- nine days) were examined before, as well as three and six (n = six) months after, revascularization of the infarct-related artery. Regional wall motion abnormalities were assessed by cine-MRI, and repetitive images of one representative slice were acquired up to 45 minutes after 0.05 mmol/kg Gd-BOPTA using a T1-w TSE-sequence. Two patients showed mid-wall/subendocardial, one patient subendocardial enhancement of MI associated with mechanical improvement after revascularization. Three patients without improvement revealed a mid-wall hypoenhanced zone within the first five minutes after injection, which was unchanged at follow-up. One patient with partial functional improvement showed transmural enhancement and a mid-wall hypoenhanced zone in adjacent areas. With this feasibility study, we concluded that mid-wall and/or subendocardial enhancement after Gd-BOPTA was associated with viable myocardium, whereas detection of microvascular obstruction correlating with scar formation is suggested by mid-wall hypoenhancement within the first five minutes after injection.