BACKGROUND: The aim of the present study was to investigate the clinical importance of microvascular obstruction (MO) on contrast-enhanced magnetic resonance imaging (MRI), comparing it with the myocardial perfusion index (MPI) assessed using first-pass MRI. METHODS AND RESULTS: Cardiac MRI was performed in 33 patients within 7 days after reperfusion of a myocardial infarction (MI). Using a bolus injection of Gd-DPTA, first-pass images were obtained with the Turbo-FLASH sequence. Time-intensity curves in the left ventricular cavity and in myocardial sections were generated and then the MPI was assessed by the maximum slope method. Late enhancement (LE) was assessed using the true-FISP sequence. According to the transmurality of LE, the patients were classified into 3 groups: Group 1 included patients with localized endocardial enhancement; Group 2, patients with transmural enhancement; Group 3, patients having LE with MO. In cases of anterior infarction, the MPI for the anterior wall and parts of the inferior wall in Group 3 was significantly lower than that for Group 1 and 2. For inferior infarction, the MPI for parts of the inferior wall in Group 3 was significantly lower than that for Group 1 and 2. CONCLUSION: MO is related to lower MPI, indicating severe microvascular damage. LE with or without MO is an important marker of perfusion status after reperfused MI.
BACKGROUND: The aim of the present study was to investigate the clinical importance of microvascular obstruction (MO) on contrast-enhanced magnetic resonance imaging (MRI), comparing it with the myocardial perfusion index (MPI) assessed using first-pass MRI. METHODS AND RESULTS: Cardiac MRI was performed in 33 patients within 7 days after reperfusion of a myocardial infarction (MI). Using a bolus injection of Gd-DPTA, first-pass images were obtained with the Turbo-FLASH sequence. Time-intensity curves in the left ventricular cavity and in myocardial sections were generated and then the MPI was assessed by the maximum slope method. Late enhancement (LE) was assessed using the true-FISP sequence. According to the transmurality of LE, the patients were classified into 3 groups: Group 1 included patients with localized endocardial enhancement; Group 2, patients with transmural enhancement; Group 3, patients having LE with MO. In cases of anterior infarction, the MPI for the anterior wall and parts of the inferior wall in Group 3 was significantly lower than that for Group 1 and 2. For inferior infarction, the MPI for parts of the inferior wall in Group 3 was significantly lower than that for Group 1 and 2. CONCLUSION: MO is related to lower MPI, indicating severe microvascular damage. LE with or without MO is an important marker of perfusion status after reperfused MI.
Authors: Agnes Mayr; Kathrin Pedarnig; Gert Klug; Michael Schocke; Otmar Pachinger; Werner Jaschke; Bernhard Metzler Journal: Int J Cardiovasc Imaging Date: 2011-10-01 Impact factor: 2.357
Authors: Anne Bethke; Limalanathan Shanmuganathan; Geir Øystein Andersen; Jan Eritsland; David Swanson; Nils Einar Kløw; Pavel Hoffmann Journal: Eur Radiol Date: 2018-07-06 Impact factor: 5.315
Authors: Anne Bethke; Limalanathan Shanmuganathan; Christian Shetelig; David Swanson; Geir Øystein Andersen; Jan Eritsland; Nils Einar Kløw; Pavel Hoffmann Journal: PLoS One Date: 2018-11-09 Impact factor: 3.240