Differentiation of reversible and irreversible myocardial injury by MR imaging with and without gadolinium-DTPA.

The current study evaluated the capability of magnetic resonance (MR) imaging to distinguish myocardium subjected to reversible and irreversible ischemic injury. Nine dogs underwent left anterior descending coronary arterial occlusion for 15 minutes (reversible injury) and nine for 1 hour (irreversible injury), followed by reperfusion for 24 hours in both groups. Six dogs from each group received 0.5 mmol/kg of gadolinium-DTPA intravenously; the remaining dogs received no contrast media. In the dogs with irreversible injury but no contrast media, there were prolonged T1 and T2 of the infarcted myocardium and adequate visualization of the infarct. The percentage of contrast between normal and infarcted myocardium was greatest on T2-weighted images. In the group with irreversible injury and contrast media, Gd-DTPA produced significant T1 shortening of injured myocardium, with resultant high signal intensity of the infarct, and significantly enhanced contrast compared with the group that did not receive Gd-DTPA. In the dogs with reversible injury, there were no regional differences in intensity or relaxation times. MR has the capability to distinguish myocardium with irreversible injury from that with reversible injury. The difference of T1 between normal and reperfused infarcted myocardium is increased by Gd-DTPA; thus, contrast between these two is enhanced on MR images.