Literature DB >> 17574129

3D and 2D delayed-enhancement magnetic resonance imaging for detection of myocardial infarction: preclinical and clinical results.

Daniel Peukert1, Michael Laule, Matthias Taupitz, Nicola Kaufels, Bernd Hamm, Marc Dewey.   

Abstract

RATIONALE AND
OBJECTIVES: The purpose was to verify whether myocardial viability can be detected by a delayed enhancement magnetic resonance imaging (MRI) approach using a rapid three-dimensional inversion-recovery fast low-angle shot (3D IR-FLASH) sequence in a preclinical and clinical setting.
MATERIALS AND METHODS: Nonreperfused myocardial infarctions were induced in eight minipigs. Both the pigs and 15 patients with suspected myocardial infarction underwent MRI using a rapid 3D IR-FLASH sequence and a two-dimensional IR-FLASH sequence as the reference standard.
RESULTS: In the pigs, a total of 52 segments with myocardial infarction were identified with both sequences and there was good agreement in transmurality of 99.5%. The infarction volume determined with the 3D IR-FLASH in the animal study (2.4 +/- 1.5 cm(3)) showed a good correlation with the histomorphometrically determined volume using triphenyltetrazolium chloride (2.3 +/- 1.2 cm(3), r = 0.98, P < .001) and the two-dimensional IR-FLASH sequence (2.3 +/- 1.4 cm(3), r = 0.99, P < .001). Eleven of 15 patients were found to have myocardial infarction in 37 myocardial segments with both sequences and there was a good agreement in transmurality of 98.8%. There was also a good correlation in the clinical study between the 3D and 2D sequences (6.9 +/- 6.7 cm(3) vs. 6.8 +/- 6.5 cm(3), r = 0.98, P < .001). In Bland-Altman analysis there was no significant under- or overestimation of the myocardial infarction volume using the 3D IR-FLASH sequence in comparison to the two-dimensional reference standard in both the preclinical and clinical study. The contrast-to-noise ratios were not significantly different between 3D and 2D sequences in the animal (34.7 +/- 1.5 vs. 33.8 +/- 2.6; P = .51) and clinical study (31.4 +/- 12.5 vs. 36.7 +/- 11.5; P = .31). The breathhold time for the 3D IR-FLASH sequence in the clinical study (20.4 +/- 2.2 s) was significantly shorter than that of the 2D IR-FLASH sequence (190.1 +/- 20.8 s, P < .001).
CONCLUSIONS: The rapid 3D IR-FLASH sequence detects myocardial infarction with high accuracy and allows a relevant reduction in acquisition time.

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Year:  2007        PMID: 17574129     DOI: 10.1016/j.acra.2007.03.006

Source DB:  PubMed          Journal:  Acad Radiol        ISSN: 1076-6332            Impact factor:   3.173


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