Volume 1, Issue 1, July 2013, Page: 1-6
Contrast Enhanced Cardiac MRI Findings Of Myocardial Infarction In Different Infarction Duration
Naglaa Mostafa Elsayed, Department of Diagnostic Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, KSA; Department of Diagnostic Radiology, Kasr Al-Aini University Hospitals,Cairo University, Egypt
Nouf Alzahrani, Department of Diagnostic Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, KSA
Received: May 19, 2013;       Published: Jun. 20, 2013
DOI: 10.11648/j.ijmi.20130101.11      View  2488      Downloads  130
Background: Cardiac MRIis an important tool in the diagnosis of myocardial infarction (MI), and in differentiating acute from chronic cases. Studying the myocardial viability of infracted myocardium is very important for decision making regarding coronary revascularization. Objective: The aim of this work was to study contrast enhanced MRI criteria of acute, subacute and chronic MI , and to evaluate the ability of MRI to differentiate between them. Patients and methods: Sixty patients (54 males and 6 females) with MI of different duration were included in the study. All patients were subjected to c MRI using magnetom Sonata 1.5 T Siemens machine. Ten ml gadolinium was given to every patient. Image analysis was performed, then statistical analysis was done using SPSS program 16. P value was considered significant if > 0.05.Results: Left ventricular dilatation and thin infarction wall were seen more in chronic and subacuteMI. Most cases of MI showed hypokinesia or akinesia regardless the infarction duration. In post contrast images, microvascular obstruction (MVO) was seen more in acute MI, while delayed contrast enhancement was more with chronic MI (due to scar tissue). Conclusion: cMRI could diagnose anatomical and functional abnormalities that associate MI. some criteria were more with acute MI and others were more with chronic MI. however, some degree of overlap was seen between both.
Cardiac MRI, Myocardial Infarction, Delayed Enhancement
To cite this article
Naglaa Mostafa Elsayed, Nouf Alzahrani, Contrast Enhanced Cardiac MRI Findings Of Myocardial Infarction In Different Infarction Duration, International Journal of Medical Imaging. Vol. 1, No. 1, 2013, pp. 1-6. doi: 10.11648/j.ijmi.20130101.11
Marra MP, Lima JA, and Iliceto S. MRI in acute myocardial infarction. European Heart Journal 2011; 32: 284–293
Claussen JV, Rochitte CE, Wu KC, Kamel IR, Foo TK, Lima JA, Bluemke DA. Delayed Enhancement MR Imaging: Utility in Myocardial Assessment. RSNA, 2006
Choi BW. Differentiation of Acute Myocardial Infarction from Chronic Myocardial Scar with MRI. Korean J Radiol 2006; 7(1): 1-3
Abdel-Aty H, Zagrosek A, Schulz-Menger J, Taylor AJ,Messroghli D, Kumar A, et al. Delayed enhancement and T2-weighted cardiovascular magnetic resonance imaging differentiateacute from chronic myocardial infarction. Circulation 2004; 109: 2411-2416
Baroldi G, Silver MD, De Maria R, Parodi O, Pellegrini A.Lipomatous metaplasia in left ventricular scar. Can J Cardiol1997; 13: 65-71
Wu KC, Zerhouni EA, Judd RM, et al. Prognostic significance of microvascular obstruction by magnetic resonance imaging in patients with acute myocardial infarction. Circulation1998; 97: 765–772.
Mather AN, Fairbairn TA, Artisnj, greenwood JP, Plein S. Timing of Cardiovascular MR Imaging after Acute Myocardial Infarction: Effect on Estimates of Infarct Characteristics and Prediction of Late Ventricular Remodeling. RSNA, 2011
Kim RJ, Wu E, Rafael A, Chen EL, Parker MA, Simonetti O, Klocke FJ, Bonow RO, Judd RM.The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med 2000; 343(20): 1445-1453.
Judd RM, Lugo-Olivieri CH, Arai M, Kondo T, Croisille P, Lima JA, Mohan V,Becker LC, Zerhouni EA.Physiological basis of myocardial contrast enhancement in fast magnetic resonance images of a 2-day-old reperfused canineinfarcts. Circulation 1995; 92: 1902 –1910.
Lima JA, Judd RM, Bazille A, Schulman SP, Atalar E, Zerhouni EA. Regional heterogeneity of human myocardial infarcts demonstrated by contrast enhancedMRI. Circulation 1995;92:1117 –1125
Czubryt MP. Common threads in cardiac fibrosis, infarct scar formation, and wound healing. Fibrogenesis& Tissue Repair 2012, 5:19
Willems IE, Havenith MG, De Mey JG, Daemen MJ:The alpha-smooth muscle actin-positive cells in healing human myocardial scars.Am J Pathol 1994, 145: 868-
Rehwald WG, Fieno DS, Chen EL, et al. Myocardial magnetic resonance imaging contrast agent concentrations after reversible and irreversible ischemic injury Circulation 2002; 105: 224-229
Baer FM, Smolarz K, Jungehulsing M, et al.Chronic myocardial infarction: assessment of morphology, function, and perfusion by gradient echo magnetic resonance imaging and 99mTc-methoxyisobutyl-isonitrile SPECT. Am Heart J1992; 123: 636–645.
Sechtem U, Baer F, Voth E. Myocardial viability. In: Manning W, Pennell D, eds. Cardiovascular Magnetic Resonance. 1st ed. New York, NY: Churchill Livingstone; 2002: 167–185.
S. Dymarkowski and H. Bosmans. Cardiac MRI Physics. 2005; Berlin Heidelberg :Springer .
Raymond J. Kim Hanns B. Hillenbrand, Robert M. Judd. Evaluation of Myocardial Viability by MRI. 2000USA: Urban & Vogel
Sola S, White RD, Desai M.MRI of the heart: Promises fulfilled? Cleveland Clinic Journal OF Medicine 2006; 73(7): 663-670
BarkhausenJ, Hunold P, Eggebrecht H, et al. Detection and characterization of intracardiac thrombi on MR imaging. AJR Am J Roentgenol2002; 179: 1539–1544.
Kim HW,Farzaneh-Far A and Kim RJ.Cardiovascular Magnetic Resonance in Patients with Myocardial Infarction. J Am CollCardiol 2010; 55: 1-16
Oshinski JN, Yang Z, Jones JR, Mata JF, French BA. Imaging time after Gd-DTPAinjection is critical in using delayed enhancement to determine infarct size accurately with magnetic resonance imaging. Circulation 2001; 104: 2838 – 2842.
Saeed M, Lund G, Wendland MF, Bremerich J, Weinmann H, Higgins CB.
Magnetic resonance characterization of the peri-infarction zone of reperfused myocardial infarction with necrosis-specific and extracellular nonspecific contrastmedia. Circulation 2001; 103: 871 –876.
Ingkanisorn WP, Rhoads KL, Aletras AH, Kellman P, Arai AE. Gadolinium delayed enhancement cardiovascular magnetic resonance correlates with clinical measures of myocardial infarction. J Am CollCardiol 2004; 43: 2253–2259.
Thornhill RE, Prato FS, Wisenberg G. The assessment of myocardial viability: a review of current diagnostic imaging approaches. J CardiovascMagnReson. 2002; 4: 381–410.
Choi KM, Kim RJ, Gubernikoff G, et al.Transmural extent of acute myocardial infarction predicts long-term improvement in contractile function. Circulation. 2001; 104: 1101–1107.
Wu E, Judd RM, Vargas JD, et al. Visualization of presence, location, and transmural extent of healed Q- wave and non-Q-wave myocardial infarction.Lancet. 2001; 357: 21–28.
Mahrholdt H, Wagner A, Holly TA, et al.Reproducibility of chronic infarct size measurement by contrast-enhanced magnetic resonance imaging.Circulation. 2002; 106: 2322–2327.
Mollet NR, Dymarkowski S, Volders W, Wathiong J, Herbots L, Rademakers FE,BogaertJ.Visualization of ventricular thrombi with contrast-enhanced magneticresonance imaging in patients with ischemic heart disease. Circulation 2002; 106: 2873 –2876.
Tarantini G, Razzolini R, Cacciavillani L, Bilato C, Sarais C, Corbetti F, Marra MP, Napodano M, Ramondo A, Iliceto S.Influence of transmurality, infarct size, andsevere microvascular obstruction on left ventricular remodeling and functionafter primary coronary angioplasty. Am J Cardiol 2006; 98:1033 –1040?
Sechtem U, MahrholdtH.Can delayed enhancement and T2- weighted imaging distinguish acute from chronic myocardial infarction? Nat ClinPractCardiovasc Med 2004;1:22-23
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