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Cardiac Imaging |
1 From Siemens Medical Systems, 448 E Ontario St, Chicago, IL 60611 (O.P.S., J.M.B.); and Feinberg Cardiovascular Research Institute (R.J.K., D.S.F., H.B.H., E.W., R.M.J.) and Depts of Medicine (R.J.K., E.W., R.M.J.), Radiology (J.P.F.), and Biomedical Engineering (D.S.F., R.M.J.), Northwestern Univ Medical School, Chicago, Ill. Received Nov 23, 1999; revision requested Jan 27, 2000; revision received Apr 3; accepted Apr 20. Supported by Northwestern Memorial Foundation and NIH NHLBI grant R01-HL63268. Address correspondence to O.P.S. (e-mail: orlando.simonetti@sms.siemens.com).
PURPOSE: To design a segmented inversion-recovery turbo fast low-angle shot (turboFLASH) magnetic resonance (MR) imaging pulse sequence for the visualization of myocardial infarction, compare this technique with other MR imaging approaches in a canine model of ischemic injury, and evaluate its utility in patients with coronary artery disease.
MATERIALS AND METHODS: Six dogs and 18 patients were examined. In dogs, infarction was produced and images were acquired by using 10 different pulse sequences. In patients, the segmented turboFLASH technique was used to acquire contrast material–enhanced images 19 days ± 7 (SD) after myocardial infarction.
RESULTS: Myocardial regions of increased signal intensity were observed in all animals and patients at imaging. With the postcontrast segmented turboFLASH sequence, the signal intensity of the infarcted myocardium was 1,080% ± 214 higher than that of the normal myocardium in dogs—nearly twice that of the next best sequence tested and approximately 10-fold greater than that in previous reports. All 18 patients with myocardial infarction demonstrated high signal intensity at imaging. On average, the signal intensity of the high-signal-intensity regions in patients was 485% ± 43 higher than that of the normal myocardium.
CONCLUSION: The segmented inversion-recovery turboFLASH sequence produced the greatest differences in regional myocardial signal intensity in animals. Application of this technique in patients with infarction substantially improved differentiation between injured and normal regions.
Index terms: Animals • Heart, MR, 121411, 51.121413, 51.121416, 51.121417, 51.12142, 51.12143, 51.12146 • Magnetic resonance (MR), comparative studies, 121411, 51.121413, 51.121416, 51.121417, 51.12142, 51.12143, 51.12146 • Magnetic resonance (MR), contrast enhancement, 121411, 51.121413, 51.121416, 51.121417, 51.12142, 51.12143, 51.12146 • Magnetic resonance (MR), inversion recovery, 51.12143 • Magnetic resonance (MR), pulse sequences, 121411, 51.121413, 51.121416, 51.121417, 51.12142, 51.12143, 51.12146 • Myocardium, infarction, 51.771
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U. S. Valeti, R. A. Nishimura, D. R. Holmes, P. A. Araoz, J. F. Glockner, J. F. Breen, S. R. Ommen, B. J. Gersh, A. J. Tajik, C. S. Rihal, et al. Comparison of Surgical Septal Myectomy and Alcohol Septal Ablation With Cardiac Magnetic Resonance Imaging in Patients With Hypertrophic Obstructive Cardiomyopathy J. Am. Coll. Cardiol., January 23, 2007; 49(3): 350 - 357. [Abstract] [Full Text] [PDF]
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T. Ibrahim, H. P. Bulow, T. Hackl, M. Hornke, S. G. Nekolla, M. Breuer, A. Schomig, and M. Schwaiger Diagnostic Value of Contrast-Enhanced Magnetic Resonance Imaging and Single-Photon Emission Computed Tomography for Detection of Myocardial Necrosis Early After Acute Myocardial Infarction J. Am. Coll. Cardiol., January 16, 2007; 49(2): 208 - 216. [Abstract] [Full Text] [PDF]
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B. Sievers, M. D. Elliott, L. M. Hurwitz, T. S.E. Albert, I. Klem, W. G. Rehwald, M. A. Parker, R. M. Judd, and R. J. Kim Rapid Detection of Myocardial Infarction by Subsecond, Free-Breathing Delayed Contrast-Enhancement Cardiovascular Magnetic Resonance Circulation, January 16, 2007; 115(2): 236 - 244. [Abstract] [Full Text] [PDF]
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H Mahrholdt, I Klem, and U Sechtem Cardiovascular MRI for detection of myocardial viability and ischaemia Heart, January 1, 2007; 93(1): 122 - 129. [Full Text] [PDF]
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A. K. Attili and P. N. Cascade CT and MRI of Coronary Artery Disease:Evidence-Based Review. Am. J. Roentgenol., December 1, 2006; 187(6 Suppl): S483 - S499. [Abstract] [Full Text] [PDF]
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A. K. Attili, J. M. Foral, U. J. Schoepf, P. N. Cascade, and F. S. Chew CT and MRI of Coronary Artery Disease: Self-Assessment Module Am. J. Roentgenol., December 1, 2006; 187(6_Supplement): S500 - S504. [Abstract] [Full Text] [PDF]
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A. Kumar, H. Abdel-Aty, I. Kriedemann, J. Schulz-Menger, C. M. Gross, R. Dietz, and M. G. Friedrich Contrast-Enhanced Cardiovascular Magnetic Resonance Imaging of Right Ventricular Infarction J. Am. Coll. Cardiol., November 21, 2006; 48(10): 1969 - 1976. [Abstract] [Full Text] [PDF]
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J. P. Finn, K. Nael, V. Deshpande, O. Ratib, and G. Laub Cardiac MR Imaging: State of the Technology. Radiology, November 1, 2006; 241(2): 338 - 354. [Abstract] [Full Text] [PDF]
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J. P. Finn, R. Saleh, S. Thesen, S. G. Ruehm, M. H. Lee, J. Grinstead, J. S. Child, and G. Laub MR Imaging with Remote Control: Feasibility Study in Cardiovascular Disease Radiology, November 1, 2006; 241(2): 528 - 537. [Abstract] [Full Text] [PDF]
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H. Mahrholdt, A. Wagner, C. C. Deluigi, E. Kispert, S. Hager, G. Meinhardt, H. Vogelsberg, P. Fritz, J. Dippon, C. -T. Bock, et al. Presentation, Patterns of Myocardial Damage, and Clinical Course of Viral Myocarditis Circulation, October 10, 2006; 114(15): 1581 - 1590. [Abstract] [Full Text] [PDF]
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D. Haghi, A. Athanasiadis, T. Papavassiliu, T. Suselbeck, S. Fluechter, H. Mahrholdt, M. Borggrefe, and U. Sechtem Right ventricular involvement in Takotsubo cardiomyopathy Eur. Heart J., October 2, 2006; 27(20): 2433 - 2439. [Abstract] [Full Text] [PDF]
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K Debl, B Djavidani, S Buchner, C Lipke, W Nitz, S Feuerbach, G Riegger, and A Luchner Delayed hyperenhancement in magnetic resonance imaging of left ventricular hypertrophy caused by aortic stenosis and hypertrophic cardiomyopathy: visualisation of focal fibrosis Heart, October 1, 2006; 92(10): 1447 - 1451. [Abstract] [Full Text] [PDF]
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M. R. Patel, T. S. E. Albert, D. E. Kandzari, E. F. Honeycutt, L. K. Shaw, M. H. Sketch Jr, M. D. Elliott, R. M. Judd, and R. J. Kim Acute Myocardial Infarction: Safety of Cardiac MR Imaging after Percutaneous Revascularization with Stents Radiology, September 1, 2006; 240(3): 674 - 680. [Abstract] [Full Text] [PDF]
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C. M. Bove, J. M. DiMaria, S. Voros, M. R. Conaway, and C. M. Kramer Dobutamine Response and Myocardial Infarct Transmurality: Functional Improvement after Coronary Artery Bypass Grafting--Initial Experience Radiology, September 1, 2006; 240(3): 835 - 841. [Abstract] [Full Text] [PDF]
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G. L. Raff, W. W. O'Neill, R. E. Gentry, A. Dulli, K. G. Bis, A. N. Shetty, and J. A. Goldstein Microvascular Obstruction and Myocardial Function after Acute Myocardial Infarction: Assessment by Using Contrast-enhanced Cine MR Imaging. Radiology, August 1, 2006; 240(2): 529 - 536. [Abstract] [Full Text] [PDF]
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Q. Hu, X. Wang, J. Lee, A. Mansoor, J. Liu, L. Zeng, C. Swingen, G. Zhang, J. Feygin, K. Ochiai, et al. Profound bioenergetic abnormalities in peri-infarct myocardial regions Am J Physiol Heart Circ Physiol, August 1, 2006; 291(2): H648 - H657. [Abstract] [Full Text] [PDF]
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T. Baks, F. Cademartiri, A. D. Moelker, A. C. Weustink, R.-J. van Geuns, N. R. Mollet, G. P. Krestin, D. J. Duncker, and P. J. de Feyter Multislice Computed Tomography and Magnetic Resonance Imaging for the Assessment of Reperfused Acute Myocardial Infarction J. Am. Coll. Cardiol., July 4, 2006; 48(1): 144 - 152. [Abstract] [Full Text] [PDF]
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F. J. Klocke, E. Wu, and D. C. Lee "Shades of Gray" in Cardiac Magnetic Resonance Images of Infarcted Myocardium: Can They Tell Us What We'd Like Them to? Circulation, July 4, 2006; 114(1): 8 - 10. [Full Text] [PDF]
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A. T. Yan, A. J. Shayne, K. A. Brown, S. N. Gupta, C. W. Chan, T. M. Luu, M. F. Di Carli, H. G. Reynolds, W. G. Stevenson, and R. Y. Kwong Characterization of the Peri-Infarct Zone by Contrast-Enhanced Cardiac Magnetic Resonance Imaging Is a Powerful Predictor of Post-Myocardial Infarction Mortality Circulation, July 4, 2006; 114(1): 32 - 39. [Abstract] [Full Text] [PDF]
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R. Y. Kwong, A. K. Chan, K. A. Brown, C. W. Chan, H. G. Reynolds, S. Tsang, and R. B. Davis Impact of Unrecognized Myocardial Scar Detected by Cardiac Magnetic Resonance Imaging on Event-Free Survival in Patients Presenting With Signs or Symptoms of Coronary Artery Disease Circulation, June 13, 2006; 113(23): 2733 - 2743. [Abstract] [Full Text] [PDF]
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R. M. Setser, J. K. Kim, Y. C. Chung, K. Chen, A. E. Stillman, R. Loeffler, O. P. Simonetti, J. A. Weaver, M. L. Lieber, and R. D. White Cine Delayed-Enhancement MR Imaging of the Heart: Initial Experience Radiology, June 1, 2006; 239(3): 856 - 862. [Abstract] [Full Text] [PDF]
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