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Myocardial Viability: Rapid Assessment with Delayed Contrast-enhanced MR Imaging with Three-dimensional Inversion-Recovery Prepared Pulse Sequence¹

¹ From Medical Clinic I (H.P.K.) and the Dept of Medical Statistics (N.S.H.), University Hospital Aachen, Pauwelstrasse 30, 52057 Aachen, Germany; and Depts of Cardiology (T.S.P., A.M.B., A.C.v.R.) and Clinical Physics and Informatics (M.B.M.H.), Vrÿe University Medical Center, Amsterdam, the Netherlands. Supported by Netherlands Heart Foundation grant 2001.158. H.P.K. supported in part by grants from the Faculty of Medicine of the Rheinisch-Westfälische Technische Hochschule, Aachen, Germany, and by the Grimmke-Stiftung, Düsseldorf, Germany. Received Sept 11, 2002; revision requested Nov 7; final revision received May 12, 2003; accepted June 16. Address correspondence to H.P.K. (e-mail: hkuehl@ukaachen.de).

Contrast-enhanced magnetic resonance (MR) imaging allows detection of nonviable myocardium. The authors compared a one–breath-hold three-dimensional inversion-recovery gradient-echo MR sequence with a multiple–breath-hold two-dimensional inversion-recovery gradient-echo MR sequence for the detection of nonviable myocardium. On the basis of a quantitative and qualitative approach, total myocardial area and contrast material–enhanced area, as well as the presence and spatial extent of hyperenhancement, were analyzed separately for each MR image obtained with each sequence in 10 patients with chronic ischemic heart disease. Findings for total myocardial area and contrast-enhanced area agreed well between the two sequences. A high level of agreement was also found for the presence of hyperenhancement ( = 0.84), while agreement was poor for the transmural extent of hyperenhancement ( = 0.32), which was attributed to the blurred appearance of the three-dimensional MR images. Findings with the one–breath-hold three-dimensional MR sequence allow assessment of nonviable myocardium with good agreement with those with the multiple–breath-hold two-dimensional MR sequence.

© RSNA, 2003

Index terms: Heart, MR, 511.121419, 511.12143 • Myocardium, infarction, 511.771 • Myocardium, MR, 511.121419, 511.12143

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