Avinash Kali1, Ivan Cokic1, Richard L Q Tang1, Hsin-Jung Yang1, Behzad Sharif1, Eduardo Marbán1, Debiao Li1, Daniel S Berman1, Rohan Dharmakumar2. 1. From the Biomedical Imaging Research Institute, Department of Biomedical Sciences (A.K., I.C., R.L.Q.T., H.-J.Y., B.S., D.L., R.D.) and Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (E.M., D.L., D. S. B., R.D.); Department of Bioengineering (A.K., H.-J.Y.) and Department of Medicine, David Geffen School of Medicine (D. S. B., R.D.), University of California, Los Angeles, CA; and Department of Radiology, Northwestern University, Chicago, IL (A.K., R.L.Q.T., D.L., R.D.). 2. From the Biomedical Imaging Research Institute, Department of Biomedical Sciences (A.K., I.C., R.L.Q.T., H.-J.Y., B.S., D.L., R.D.) and Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (E.M., D.L., D. S. B., R.D.); Department of Bioengineering (A.K., H.-J.Y.) and Department of Medicine, David Geffen School of Medicine (D. S. B., R.D.), University of California, Los Angeles, CA; and Department of Radiology, Northwestern University, Chicago, IL (A.K., R.L.Q.T., D.L., R.D.). rohandkumar@csmc.edu.
Abstract
BACKGROUND: Late-gadolinium-enhanced (LGE) cardiac MRI (CMR) is a powerful method for characterizing myocardial infarction (MI), but the requisite gadolinium infusion is estimated to be contraindicated in ≈20% of patients with MI because of end-stage chronic kidney disease. The purpose of this study is to investigate whether T1 CMR obtained without contrast agents at 3 T could be an alternative to LGE CMR for characterizing chronic MIs using a canine model of MI. METHODS AND RESULTS: Canines (n=29) underwent CMR at 7 days (acute MI [AMI]) and 4 months (chronic MI [CMI]) after MI. Infarct location, size, and transmurality measured by using native T1 maps and LGE images at 1.5 T and 3 T were compared. Resolution of edema between AMI and CMI was examined with T2 maps. T1 maps overestimated infarct size and transmurality relative to LGE images in AMI (P=0.016 and P=0.007, respectively), which was not observed in CMI (P=0.49 and P=0.81, respectively) at 3 T. T1 maps underestimated infarct size and transmurality relative to LGE images in AMI and CMI (P<0.001) at 1.5 T. Relative to the remote territories, T1 of the infarcted myocardium was increased in CMI and AMI (P<0.05), and T2 of the infarcted myocardium was increased in AMI (P<0.001) but not in CMI (P>0.20) at both field strengths. Histology showed extensive replacement fibrosis within the CMI territories. CMI detection sensitivity and specificity of T1 CMR at 3 T were 95% and 97%, respectively. CONCLUSIONS: Native T1 maps at 3 T can determine the location, size, and transmurality of CMI with high diagnostic accuracy. Patient studies are necessary for clinical translation.
BACKGROUND: Late-gadolinium-enhanced (LGE) cardiac MRI (CMR) is a powerful method for characterizing myocardial infarction (MI), but the requisite gadolinium infusion is estimated to be contraindicated in ≈20% of patients with MI because of end-stage chronic kidney disease. The purpose of this study is to investigate whether T1 CMR obtained without contrast agents at 3 T could be an alternative to LGE CMR for characterizing chronic MIs using a canine model of MI. METHODS AND RESULTS:Canines (n=29) underwent CMR at 7 days (acute MI [AMI]) and 4 months (chronic MI [CMI]) after MI. Infarct location, size, and transmurality measured by using native T1 maps and LGE images at 1.5 T and 3 T were compared. Resolution of edema between AMI and CMI was examined with T2 maps. T1 maps overestimated infarct size and transmurality relative to LGE images in AMI (P=0.016 and P=0.007, respectively), which was not observed in CMI (P=0.49 and P=0.81, respectively) at 3 T. T1 maps underestimated infarct size and transmurality relative to LGE images in AMI and CMI (P<0.001) at 1.5 T. Relative to the remote territories, T1 of the infarcted myocardium was increased in CMI and AMI (P<0.05), and T2 of the infarcted myocardium was increased in AMI (P<0.001) but not in CMI (P>0.20) at both field strengths. Histology showed extensive replacement fibrosis within the CMI territories. CMI detection sensitivity and specificity of T1 CMR at 3 T were 95% and 97%, respectively. CONCLUSIONS: Native T1 maps at 3 T can determine the location, size, and transmurality of CMI with high diagnostic accuracy. Patient studies are necessary for clinical translation.
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