MR imaging of reperfused myocardial infarction: comparison of necrosis-specific and intravascular contrast agents in a cat model

PURPOSE: To compare T2-weighted and Gadomer-17- and bis-gadolinium mesoporphyrins-enhanced magnetic resonance (MR) images for distinguishing reversibly from irreversibly damaged myocardium in a cat model of reperfused myocardial infarction. MATERIALS AND METHODS: Twelve cats underwent 90 minutes of occlusion and 90 minutes of reperfusion of the left anterior descending coronary artery. After baseline T1- and T2-weighted MR images were obtained, Gadomer-17-enhanced and bis-gadolinium mesoporphyrins-enhanced T1-weighted images were sequentially obtained for 6 hours and 2 hours, respectively. After MR imaging, all cats were sacrificed for 2,3,5-triphenyltetrazolium chloride (TTC) histochemical tissue staining. Areas of abnormal signal intensity on T2-weighted and Gadomer-17-enhanced and bis-gadolinium mesoporphyrins-enhanced T1-weighted MR images were compared with the areas of infarction seen at TTC histochemical staining by using repeated-measures two-way analysis of variance, linear regression analysis, and Bland-Altman analysis. RESULTS: Mean areas of abnormally high signal intensity on T2-weighted and Gadomer-17-enhanced T1-weighted MR images (43.9% of the left ventricular surface area +/- 11.9 [SD] and 37.7% +/- 10.1, respectively) were significantly larger than the mean area of myocardial infarction at TTC staining (25.7% +/- 12.5) (P <.001). However, there was excellent correlation between the size of an enhancing area on bis-gadolinium mesoporphyrins-enhanced T1-weighted MR images and that of myocardial infarction at TTC staining (r = 0.916, P <.001). CONCLUSION: bis-Gadolinium mesoporphyrins-enhanced T1-weighted MR images accurately reflect the area of infarction, whereas the size of infarction is overestimated on T2-weighted and Gadomer-17-enhanced T1-weighted MR images, which seem to depict the periinfarct area as well as the infarct area.     

Irreversibly damaged myocardium at MR imaging with a necrotic tissue-specific contrast agent in a cat model

PURPOSE: To investigate the capability of a necrosis-avid magnetic resonance (MR) contrast agent, bis-gadolinium mesoporphyrins, for assessment of irreversibly damaged myocardium and to evaluate the time course of signal enhancement in the reperfused myocardium. MATERIALS AND METHODS: Nine cats were subjected to 90 minutes of occlusion of the left anterior descending coronary artery followed by 90 minutes of reperfusion. Contrast material-enhanced T1-weighted spin-echo images were obtained for 12 hours in five cats and 6 hours in four cats. Pathologic examinations of the resected specimens were performed with 2'3'5-triphenyl tetrazolium chloride (TTC) histochemical staining and electron microscopy. The size of enhanced area on MR images was compared with that of irreversibly damaged myocardium with TTC staining. The time course of signal enhancement was evaluated. RESULTS: The size of enhanced area on MR images was well correlated with that of irreversibly damaged myocardium with TTC staining. Maximum enhancement occurred 1-3 hours after administration of the contrast material, with mean enhancement of 171% that of normal myocardium. Electron microscopic examinations showed severe myocardial damage in the irreversibly damaged myocardium but only mild edematous changes in the reversibly damaged myocardium. CONCLUSION: MR images enhanced with bis-gadolinium mesoporphyrins provide accurate sizing of irreversibly damaged myocardium with a strong and persistent signal enhancement in the reperfused myocardium.     

Serial assessment of myocardial infarction by using gated MR imaging and Gd-DTPA

In order to assess the usefulness of Gd-DTPA in the evaluation of myocardial infarction, 17 patients were examined with gated MR imaging. Scans were made by using a spin-echo pulse sequence before and after IV administration of 0.15 mmol/kg of Gd-DTPA. The images were made at four intervals (average of 5, 12, 30, and 90 days) after the onset of the infarction. Gd-DTPA uptake at the infarcted area was graded as marked, moderate, or no increase in signal intensity by visual inspection. At these four time intervals, an area of increased signal intensity in the infarcted myocardium was detected on T1-weighted images after administration of Gd-DTPA in 14 (82%) of 17 cases, 16 (94%) of 17 cases, six (38%) of 16 cases, and three (21%) of 14 cases, respectively. Markedly increased signal intensity in infarcted areas was shown on T1-weighted images with Gd-DTPA at 5 and 12 days. The ratio of gadolinium uptake in the infarcted area to that in normal myocardium also was evaluated. At 5 and 12 days, the mean increase in signal intensity in the infarcted area was significantly higher than that in a normal area, but not at 30 and 90 days. Increased signal intensity also was apparent on T2-weighted images without Gd-DTPA at 5 and 12 days; however, the use of late echo reduced the signal-to-noise ratio, leading to image degradation. Uptake of Gd-DTPA was a positive marker in acute myocardial infarction, but no significant uptake of Gd-DTPA occurred in chronic myocardial infarction.     

High field magnetic resonance imaging evaluation of superparamagnetic iron oxide nanoparticles in a permanent rat myocardial infarction

RATIONALE AND OBJECTIVES: The purpose of this study was to evaluate superparamagnetic iron oxide (SPIO) nanoparticles to discriminate infarcted from normal tissue after myocardial infarction using high field MR imaging (7 tesla).MATERIALS AND METHODS: Permanent myocardial infarction was induced in rats. SPIO nanoparticles (1 mg Fe/kg) were assessed with T1-weighted gradient echo sequence to visualize the myocardial infarction 48 hours after ligature (n = 6). Furthermore, MR Imaging was performed using a T2-weighted RARE sequence and nanoparticles were injected (5 or 10 mg Fe/kg) on 36 rats 5, 24 or 48 hours after infarction. RESULTS: No changes in contrast between normal and infarcted myocardium was observed after nanoparticle injection on T1-weighted images. However, nanoparticles induced a significant contrast increase between normal and infarcted myocardium on T2-weighted images whatever the delay between infarction and imaging (2.99 +/- 1.66 preinjection vs. 7.82 +/- 1.96 after SPIO injection at a dose of 5 mg Fe/kg 5 hours postinfarction, P = 0.0001). CONCLUSIONS: Nanoparticle injection made it possible to discriminate normal from infarcted myocardium on T2-weighted images. However, the high magnetic field prevented the visualization of the T1 effect of SPIO nanoparticles.     

Early-phase myocardial infarction: evaluation by MR imaging

In vivo gated magnetic resonance (MR) imaging was performed in 12 dogs immediately after occlusion of the left anterior descending coronary artery and serially up to 5 hours and again between 4 and 14 days. This was done to evaluate the appearance of acute myocardial infarcts and to determine how soon after coronary artery occlusion MR imaging can demonstrate the site of acute myocardial ischemia. In nine dogs with postmortem evidence of myocardial infarction, regional increase of signal intensity of the myocardium was present by 3 hours after coronary artery occlusion and conformed to the site of myocardial infarct found at autopsy. The signal intensity on T2-weighted images of the infarcted myocardium was significantly greater than that of normal myocardium at 3, 4, and 5 hours after occlusion. The T2 (spin-spin) relaxation time was significantly prolonged in the region of myocardial infarct at 3, 4, and 5 hours postocclusion compared with normal myocardium. Myocardial wall thinning and increased intracavitary flow signal were found in six dogs with comparable pre- and postocclusion images in late systole.     

Occlusive and reperfused myocardial infarcts: MR imaging differentiation with nonionic Gd-DTPA-BMA

To increase the time during which effective contrast exists between normal and infarcted myocardium, a high dose (0.6 mmol/kg) of the nonionic contrast medium gadolinium diethylenetriaminepentaacetic acid bismethylamide (Gd-DTPA-BMA) was used to distinguish between occlusive and reperfused myocardial infarctions in rats. After administration of Gd-DTPA-BMA, there was clear and persistent demarcation of both occlusive and reperfused infarcts on T1-weighted MR images. In occlusive infarcts, normal, infarcted, and periinfarcted myocardium could be identified. High signal intensity was evident for 60 minutes in a band straddling the border between infarcted and normal myocardium, namely, the periinfarction zone. In the reperfused infarct, normal and infarcted myocardium could be identified. The reperfused zone was immediately enhanced after injection of Gd-DTPA-BMA. A differential pattern of enhancement between occlusive and reperfused myocardial infarcts was evident for 1 hour. Thus, Gd-DTPA-BMA has the potential to allow (a) depiction of occlusive and reperfused acute myocardial infarcts, (b) documentation of reperfusion of myocardial infarction, and (c) distinction between occlusive and reperfused infarction.     

Gd—DTPA增强MRI诊断心肌梗塞

15例心脏作Gd-DTPA增强前后MRI检查,增强后为连续动态观察。其中7例为正常对照;7例为心肌梗塞(包括5例亚急性和2例慢性心肌梗塞);1例为陈旧性心肌梗塞。结果显示:增强前正常心肌信号率与梗塞心肌信号率无差别。增强后梗塞心肌信号率既高于增强前也明显高于其周围的正常心肌。无论肉眼观察还是信号测量均发现Gd-DTPA增强MRI能诊断心肌梗塞,改善心肌梗塞的显示。作者对增强后心肌信号率的系列变化作了描述。     

Magnetic resonance imaging of myocardial infarction using albumin-(Gd-DTPA), a macromolecular blood-volume contrast agent in a rat model

Magnetic resonance (MR) contrast enhancement of acute myocardial infarction was studied in rats using albumin-(Gd-DTPA), a paramagnetic macromolecule with prolonged intravascular retention after intravenous injection. Histologic examination and distribution measurements of radiolabeled microspheres confirmed induction of regional myocardial infarction after ligation of the left coronary artery. ECG-gated spin-echo images at 2.0 Tesla, employing short, T1-weighted pulse sequence settings, demonstrated time-persistent and significant (P less than .05) enhancement of normal myocardium (66%) and an even greater enhancement of the infarcted area (100%), for as long as 60 minutes after injection of 160 mg/kg albumin-(Gd-DTPA). The contrast difference between normal and infarcted myocardium was increased significantly (P less than .05) after administration of albumin-(Gd-DTPA). The prolonged enhancing effects of albumin-(Gd-DTPA) on MR images are useful for evaluating regional differences in blood volume and capillary integrity between normal and infarcted myocardium.     

Efficacy of contrast-enhanced MR imaging in cardiomyopathy: an experimental study using Bio14.6 hamsters

RATIONALE AND OBJECTIVES: Myocardial fibrosis was evaluated with magnetic resonance (MR) imaging in Bio14.6 hamsters. MATERIALS AND METHODS: Gated gradient-echo T1-weighted images and spin-echo images with gadopentetate dimeglumine enhancement (0.2 mmol/kg) were obtained. RESULTS: Myocardial enhancement persisted for 13 minutes after administration of gadopentetate dimeglumine, and myocardial signal intensity peaked at 13 minutes on gradient-echo T1-weighted images. The enhanced areas were greater in Bio14.6 hamsters at 25-42 weeks than at 10 weeks. Pathologic data revealed enhancement with inflammation at 10 weeks and fibrosis with vessel proliferation at 25-42 weeks. Pathologic fibrotic change was greater at 32-42 weeks than at 10 weeks. The myocardium of 42-week-old Bio14.6 hamsters showed remarkable contrast enhancement, which continued for 13 minutes. There was no correlation between gadolinium enhancement and pathologic findings in the evaluation of myocardial degeneration and fibrosis. CONCLUSION: Gadolinium-enhanced MR imaging was useful for estimating myocardial fibrotic changes with vessel proliferation and myocardial damage.     

Infarcted myocardium in pigs: MR imaging enhanced with slow-interstitial-diffusion gadolinium compound P760.

PURPOSE: To assess the value of P760, a gadolinium chelate with slow interstitial diffusion and high relaxivity, for magnetic resonance (MR) imaging of acute myocardial infarction in pigs. MATERIALS AND METHODS: First-pass gradient-echo MR imaging and spin-echo MR imaging were performed with P760 and then with gadoterate meglumine in eight pigs with occlusive acute myocardial infarction. P760 signal intensity enhancement and clearance were compared with those of gadoterate meglumine. RESULTS: The first-pass enhancement ratio of P760 in normal myocardium was higher than that in infarcted myocardium (1.37 +/- 0.06 [SEM] vs 1.05 +/- 0.03, P = .03). The myocardial first pass showed a blood pool-like curve for P760. The blood pool enhancement ratio 40 seconds after injection was higher for P760 than for gadoterate meglumine (left ventricular cavity, 1.75 +/- 0.06 vs 1.45 +/- 0.06, P = .009). Spin-echo MR imaging showed improved contrast between normal and infarcted myocardium after P760 administration: The ratio before contrast material administration was 0.21 +/- 0.03, that at 15 minutes was 0.48 +/- 0.05 (P = .002), and that at 25 minutes was 0.47 +/- 0.07 (P = .003). CONCLUSION: P760 is an MR imaging contrast agent characterized by low diffusion, a blood pool effect soon after low-dose administration, and fast elimination. This agent is useful for improved myocardial perfusion MR imaging of acute myocardial infarction.     

Value of magnetic resonance imaging in patients with a recent myocardial infarction: Comparison with planar thallium-201 scintigraphy

The diagnostic accuracy of spin-echo Magnetic Resonance (MR) imaging in the detection and localization of a recent myocardial infarction (mean 4 days old) was compared to planar thallium-201 scintigraphy in 20 patients with a documented myocardial infarction. A control group of 10 subjects underwent a similar MR imaging procedure without thallium-201 scintigraphy. T1-weighted MR images (TE 30 msec) showed abnormal thinning of the infarcted left ventricular wall during systole (<50% of the opposite wall) in 11 patients (55%). On T2-weighted multi-echo MR images, (TE 30–60–90–120 msec) abnormally increased signal intensity was found in 17 patients and coincided with the location of the infarction. Thallium-201 scintigraphy detected the infarction in 18 patients. Comparison of T2-MR imaging and thallium-201 scintigraphy showed concordant findings in 82% of the left ventricular segments. In 9% of segements, thallium uptake was reduced with normal T2-MR and in 9% we found a normal thallium uptake with abnormal T2-MR findings. In all subjects of the control group, T1-MR images were normal, and only one subject showed increased signal intensity on T2-MR images. We conclude that the diagnostic accuracy of MR imaging in detecting a myocardial infarction is similar to that of T1-201 scintigraphy.     

An improved MR imaging technique for the visualization of myocardial infarction

PURPOSE: To design a segmented inversion-recovery turbo fast low-angle shot (turboFLASH) magnetic resonance (MR) imaging pulse sequence for the visualization of myocardial infarction, compare this technique with other MR imaging approaches in a canine model of ischemic injury, and evaluate its utility in patients with coronary artery disease. MATERIALS AND METHODS: Six dogs and 18 patients were examined. In dogs, infarction was produced and images were acquired by using 10 different pulse sequences. In patients, the segmented turboFLASH technique was used to acquire contrast material-enhanced images 19 days +/- 7 (SD) after myocardial infarction. RESULTS: Myocardial regions of increased signal intensity were observed in all animals and patients at imaging. With the postcontrast segmented turboFLASH sequence, the signal intensity of the infarcted myocardium was 1,080% +/- 214 higher than that of the normal myocardium in dogs-nearly twice that of the next best sequence tested and approximately 10-fold greater than that in previous reports. All 18 patients with myocardial infarction demonstrated high signal intensity at imaging. On average, the signal intensity of the high-signal-intensity regions in patients was 485% +/- 43 higher than that of the normal myocardium. CONCLUSION: The segmented inversion-recovery turboFLASH sequence produced the greatest differences in regional myocardial signal intensity in animals. Application of this technique in patients with infarction substantially improved differentiation between injured and normal regions.     

Acute, subacute, and chronic myocardial infarction: quantitative analysis of gadolinium-enhanced MR images

The value of gadolinium enhancement to enable detection of infarcted myocardium at T1-weighted magnetic resonance (MR) imaging was assessed in 84 patients after acute myocardial infarction (AMI). Five healthy subjects served as controls. All patients underwent MR imaging before and 20 minutes after administration of gadopentetate dimeglumine. Contrast enhancement of normal myocardium varied 7% +/- 4 after administration of gadopentetate dimeglumine. Mean intensity ratio after gadolinium enhancement in group 1 (imaging less than 1 week after AMI), group 2 (imaging 1-3 weeks after AMI), and group 3 (imaging 3-6 weeks after AMI) was significantly higher than before gadolinium enhancement. In group 4 (imaging more than 6 weeks after AMI), no significant difference was observed. After gadolinium enhancement, the intensity ratio was abnormally increased in 82% of the MR examinations in group 1, in 62% of group 2, in 58% of group 3, and in 12% of group 4. Gadolinium enhancement improved visualization of myocardial infarction at MR imaging up to 6 weeks after onset of symptoms and had a maximal effect within 1 week after AMI.     

Assessment of myocardial infarction in humans with (23)Na MR imaging: comparison with cine MR imaging and delayed contrast enhancement

PURPOSE: To demonstrate the feasibility of sodium 23 ((23)Na) magnetic resonance (MR) imaging for assessment of subacute and chronic myocardial infarction and compare with cine, late enhancement, and T2-weighted imaging. MATERIALS AND METHODS: Thirty patients underwent MR imaging 8 days +/- 4 (subacute, n = 15) or more than 6 months (chronic, n = 15) after myocardial infarction by using a (23)Na surface coil with a double angulated electrocardiogram-triggered three-dimensional gradient-echo sequence at 1.5 T. In addition, cine, inversion-recovery gradient-echo, and, in the subacute group, T2-weighted images (n = 9) were obtained. Myocardial infarction mass was depicted as elevated signal intensity or wall motion abnormalities and expressed as a percentage of total left ventricular mass for all modalities. Correlations were tested with correlation coefficients. RESULTS: All patients after subacute infarction and 12 of 15 patients with chronic infarction had an area of elevated (23)Na signal intensity that significantly correlated with wall motion abnormalities (subacute; r = 0.96, P <.001, and chronic; r = 0.9, P <.001); three patients had no wall motion abnormalities or elevated (23)Na signal intensity. Only 10 patients in the subacute and nine in the chronic group revealed late enhancement; significant correlation with (23)Na MR imaging occurred only in subacute group (r = 0.68, P <.05). Myocardial edema in subacute infarction correlated (r = 0.71, P <.05) with areas of elevated (23)Na signal intensity but was extensively larger. CONCLUSION: (23)Na MR imaging demonstrates dysfunctional myocardium caused by subacute and chronic myocardial infarction.     

Characteristics and pitfalls of contrast-enhanced, T1-weighted magnetization transfer images of the brain

RATIONALE AND OBJECTIVES: This study was undertaken to clarify the difference in signal pattern on contrast material-enhanced T1-weighted magnetic resonance (MR) magnetization transfer (MT) images between enhancing and nonenhancing lesions in various intracranial diseases and to determine the necessity of nonenhanced MT images for evaluating lesional contrast enhancement. MATERIALS AND METHODS: MR images of 116 patients who underwent nonenhanced T1-weighted imaging, nonenhanced MT imaging, and contrast-enhanced MT imaging were reviewed. The increase in signal intensity of lesions relative to normal brain was compared between nonenhanced T1-weighted images and contrast-enhanced MT images. Signal intensity of lesions was compared with that of the striate nucleus and white matter on contrast-enhanced MT images. True enhancement was determined by comparison with nonenhanced MT images. RESULTS: In all, 143 lesions, including 86 enhancing and 57 nonenhancing lesions, were identified among 63 patients. Almost all (99%) of the enhancing lesions were hyperintense to striate nucleus on contrast-enhanced MT images, and most (>87%) showed moderate to marked signal intensity increase from nonenhanced T1-weighted images to contrast-enhanced MT images. Most (>95%) of the nonenhancing lesions showed mild or no increase in relative signal intensity, and most (75%) were iso- or hypointense to striate nucleus on contrast-enhanced MT images. A few nonenhancing lesions (4%-6%), however, showed increase in signal intensity that was indistinguishable from true enhancement without comparison to non-enhanced MT images. CONCLUSION: Nonenhanced MT images should be obtained to assess pathologic enhancement accurately.     

Histologic confirmation of microvascular hyperpermeability to macromolecular MR contrast medium in reperfused myocardial infarction

A macromolecular MR contrast medium (MMCM) designed to permit histochemical staining and specific tissue localization, albumin-(biotin)10-(Gd-DTPA)25 (Bio-Alb-Gd), was used in a rat model of reperfused myocardial infarction to confirm the presence and distribution of microvascular hyperpermeability. T1-weighted spin-echo images were acquired before and after administration of Bio-Alb-Gd. An avidin-biotin-complex (ABC) stain, specific for the biotinylated MR contrast medium, was used to define the MMCM distribution and to detect any regional change in micro-vascular permeability related to infarction. Immediately after Bio-Alb-Gd administration, the infarcted region was enhanced, with greatest signal intensity noted at the rim and less at the center. There was a gradual increase in signal intensity of the initially hypointense central region. The steady increase in signal intensity of the central region suggested convection transport of MMCM through the interstitial space and its influx into cellular compartment after leakage from the vascular compartment. Histologic findings confirmed regional microvascular hyperpermeability corresponding to the site of infarction and a predominant rim distribution of the MMCM. Bio-Alb-Gd was identified at high microscopic power in the intravascular, interstitial, and intracellular spaces at the periphery of reperfused infarcted myocardium. Bio-Alb-Gd can be used as an MR contrast medium in reperfused infarcted myocardium to confirm the existence and to localize altered microvascular permeability to macromolecules. Bio-Alb-Gd contrast technique removes all the ambiguity between the distribution of the MR or other imaging contrast agent and the distribution of the substrate for histochemical staining.     

Incidental detection of acute myocardial infarction during routine performance of three-dimensional dynamic MR angiographic study with dynamic injection of gadolinium

We report on the MR appearance of acute myocardial infarction in a 61-year-old man with Ehlers-Danlos syndrome using motion-independent, T2-weighted echo train spin echo and immediate post-gadolinium three-dimensional gradient echo imaging performed as an MRI angiographic study of the aortic arch. The region of acute infarction was of high signal intensity on the T2-weighted images and demonstrated greatly diminished enhancement on the immediate post-gadolinium three-dimensional gradient echo images. MRI findings showed good correlation with autopsy specimens obtained within 24 hours of the MRI study.     

Acute myocardial infarction: tissue characterization with T1rho-weighted MR imaging--initial experience

Acute myocardial injury was evaluated in 21 patients by using a contrast material-enhanced T1rho-weighted cine turbo field-echo magnetic resonance (MR) imaging sequence and a delayed-enhancement sequence. In 12 of 21 patients, conventional T1-weighted contrast-enhanced cine turbo field-echo MR images were also collected for direct comparison with T1rho-weighted images. Delayed-enhancement technique distinctly characterized irreversible injury (percentage enhancement, 588% +/- 344). With T1rho weighting, percentage enhancement of irreversibly injured myocardium was 68% +/- 41, compared with 23% +/- 24 without T1rho weighting (P <.006). The addition of T1rho weighting to contrast-enhanced cine turbo field-echo MR sequences may offer a new contrast enhancement mechanism for characterization of acutely infarcted myocardium.     

Magnetic resonance imaging and histologic findings of experimental cerebral fat embolism

RATIONALE AND OBJECTIVES: The purpose of this study was to determine whether cerebral fat embolism demonstrated reversible or irreversible findings in magnetic resonance (MR) imaging over time and to compare the features in MR images with histologic findings in a cat model. MATERIALS AND METHODS: MR images were obtained serially at 2 hours, 1 and 4 days, and 1, 2, and 3 weeks after embolization with 0.05 mL of triolein into the internal carotid artery in 19 cats. Any abnormal signal intensity and change in the signal intensity were evaluated on T2-weighted images, T1-weighted images, diffusion-weighted images (DWIs; including apparent diffusion coefficient [ADC] maps), and gadolinium-enhanced T1-weighted images (Gd-T1WI) over time. After MR imaging at 3 weeks, brain tissue was obtained and evaluated for light microscopic (LM) examination using hematoxylin-eosin and Luxol fast blue staining. For electron microscopic examination, the specimens were obtained at the cortex. The histologic and MR findings were compared. RESULTS: The embolization lesions showed hyperintensity on T2-weighted images, hyperintensity, or isointensity on DWIs, hypointensity, or isointensity on ADC maps and contrast enhancement on Gd-T1WIs at 2 hours. The T2-weighted hyperintensity extended to the white matter at day 1 and decreased thereafter. Contrast enhancement decreased continuously from day 1, and hyperintensity on DWI decreased after day 4. Hypointensity on ADC maps became less prominent after day 4. By week 3, most lesions had reverted to a normal appearance on MR images and were correlated with LM findings. However, small focal lesions remained in the gray matter of 8 cats and in the white matter of 3 cats on MR images, and this correlated with the cystic changes on LM findings. Electron microscopic examination of the cortical lesions that reverted to normal at week 3 in MR images showed that most of these lesions appeared normal but showed sporadic intracapillary fat vacuoles and disruption of the endothelial walls. CONCLUSIONS: The embolized lesions of the hyperacute stage were of 2 types: type 1 lesions, showing hyperintensity on DWIs and hypointensity on ADC maps, have irreversible sequelae, such as cystic changes; whereas type 2 lesions, showing isointensity or mild hyperintensity on DWIs and ADC maps, reverted to a normal appearance in the subacute stage.     

Phosphonate-modified Gd-DTPA complexes. III: The detection of myocardial infarction by MRI

The potential of a phosphonate-modified-Gd-DTPA for MR image enhancement of myocardial infarction has been demonstrated in imaging experiments on rats. The agent, 1-hydroxy-3-aminopropane-1, 1-diphosphonate-modified-Gd-DTPA (Gd-DTPA-HPDP) accumulates in two models of myocardial infarction, (i.e., drug-induced diffusely infarcted whole hearts and in focal acute myocardial infarction from a left coronary artery ligation). The time course of the accumulation of the agent in the focal model of infarction and subsequent washout has also been followed in vitro. Results of this kinetics demonstrate that the agent first perfuses all normal fluid spaces and then slowly diffuses into the occluded zone where it is retained for a prolonged period, in sufficient quantities to be useful as an MRI contrast agent. Wash-out of the agent from normal myocardium is fast and complete with MR signal returning to background in minutes. The specificity of Gd-DTPA-HPDP for soft-tissue calcification and its retention within the infarcts permitted imaging at 1 to 2 h postinjection, (after unbound material has cleared the normal tissues). Infarcted tissue appeared as regions of increased signal intensity in T₁-weighted images (>200% enhancement), and correlated with histopathology. Unmodified Gd-DTPA was not retained under identical conditions. Gd-DTPA-HPDP permits a more accurate infarct delineation than is possible with the unmodified agent.