ABSTRACT
Twenty-six patients admitted to the Free University of Berlin University Hospital catheterization laboratory with acute myocardial infarction were studied. The diagnosis was confirmed by angiography, but acute revascularization was unsuccessful in every case. MR imaging was performed within 7 days of the acute event in 11 patients with uncomplicated clinical courses after acute infarction. Imaging was performed within 3 weeks in three additional cases, while the remaining 12 patients underwent studies more than 3 weeks after infarction. We determined signal intensity at three points within the area of infarction and at three other points in adjacent myocardial tissue. Decreased signal intensity within the area of infarction was found in native scans in 60% of all cases. Administration of gadolinium-DTPA 0.1 mmol/kg body weight was followed by a mean 70% increase in signal intensity within the zones of acute infarction, as compared to a 20% increase in surrounding myocardial tissue. In cases of subacute and chronic infarction, there was no significant signal enhancement after administration of gadolinium-DTPA. Uptake of the substance in the area of acute infarction may be a positive marker of acute myocardial necrosis and as such may prove useful in the clinical setting.
Subject(s)
Myocardial Infarction/diagnosis , Organometallic Compounds , Pentetic Acid , Acute Disease , Adult , Aged , Chronic Disease , Female , Gadolinium DTPA , Heart/anatomy & histology , Humans , Magnetic Resonance Imaging/methods , Male , Middle Aged , Myocardium/metabolismABSTRACT
We investigated 26 patients admitted to our catheterization laboratory with a diagnosis of acute myocardial infarction. In each case acute revascularization was unsuccessful, but the diagnosis was confirmed by angiography. In 11 patients with an uncomplicated course of acute myocardial infarction magnetic resonance imaging was carried out within 7 days of the acute event. In three additional cases imaging was performed within 3 weeks, while a remaining 12 patients underwent studies more than 3 weeks after the onset of symptoms. We determined signal intensity at three points within the area of infarction and at three other points in adjacent myocardial tissue. Decreased signal intensity within the area of infarction was present in native scans in 60% of all cases. Application of 0.1 mmol/kg body weight gadolinium-DTPA was followed by an average 70% increase in signal intensity within zones of acute infarction, as compared to a 20% increase in surrounding myocardial tissue. In cases of subacute and chronic infarction there was no significant signal enhancement after administration of gadolinium-DTPA. Uptake of gadolinium-DTPA in the area of acute myocardial infarction may be a positive marker of acute myocardial necrosis, which may be of potential clinical benefit.
