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DOI: 10.1148/radiol.2211001563
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Assessment of Myocardial Infarction in Humans with 23Na MR Imaging: Comparison with Cine MR Imaging and Delayed Contrast Enhancement1

Jörn J. W. Sandstede, MD, Thomas Pabst, PhD, Meinrad Beer, MD, Claudia Lipke, Kerstin Bäurle, Felix Butter, MD, Kerstin Harre, MD, Werner Kenn, MD, Wolfram Voelker, MD, Stefan Neubauer, MD and Dietbert Hahn, MD

1 From the Departments of Radiology (J.J.W.S., T.P., M.B., C.L., K.B., F.B., W.K., D.H.) and Internal Medicine (K.H., W.V.), University of Würzburg, Klinikstrasse 8, D-97070 Würzburg, Germany; and Department of Cardiovascular Medicine, Oxford University, England (S.N.). Received September 21, 2000; revision requested November 22; revision received January 31, 2001; accepted February 26. Supported by a grant from the Bundesministerium für Bildung und Forschung, IZKF Würzburg (01 KS 9603). Address correspondence to J.J.W.S. (e-mail: joern.sandstede@mail.uni-wuerzburg.de).



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  		Figure 1a. Graphs show (a) percentage of infarct sizes related to left ventricular muscle mass in patients after subacute myocardial infarction determined by using 23Na MR imaging, cine MR imaging, and late enhancement (LE) (n = 15) and (b) additional T2-weighted (T2w) imaging (n = 9).

 


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  		Figure 1b. Graphs show (a) percentage of infarct sizes related to left ventricular muscle mass in patients after subacute myocardial infarction determined by using 23Na MR imaging, cine MR imaging, and late enhancement (LE) (n = 15) and (b) additional T2-weighted (T2w) imaging (n = 9).

 


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  		Figure 2. Four MR modalities illustrate a 12-day-old posterior myocardial infarction in a 55-year-old man in the left ventricular short-axis view. A, End-diastolic cine image. B, End-systolic cine image shows a wall motion defect (arrowheads in B and C) of the posterior wall; Images obtained with an electrocardiographically triggered breath-hold sequence (field of view, 240 x 320 mm2; matrix, 126 x 256; 9.9/4.8; flip angle, 30°; section thickness, 8 mm). C, T1-weighted image obtained 15 minutes after administration of gadopentetate dimeglumine depicts a corresponding transmural late enhancement; image obtained with an inversion-recovery gradient-echo sequence (field of view, 240 x 320 mm2; matrix, 165 x 256; 7.5/3.4; inversion time, 170 msec; flip angle, 25°; section thickness, 8 mm). D, T2-weighted image also shows elevated SI for nearly the entire septum, which results in an overestimation of infarct size (arrowheads); image obtained with a turbo spin-echo sequence with "dark blood" preparation (field of view, 240 x 320 mm2; matrix, 138 x 256; repetition time = R-R - interval, 10%; echo time, 57 msec; flip angle, 140°; section thickness, 8 mm). E-H, Four contiguous sections of 23Na MR images show elevated SIs (arrowheads) of the posterior wall matching the area of WMAs; images obtained with an electrocardiographically triggered three-dimensional spoiled gradient-echo sequence (field of view, 450 x 450 mm2; matrix, 64 x 128; 21/3.1; flip angle, 70°; section thickness, 16 mm).

 


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  		Figure 3. Three MR modalities depict a 3-year-old anteroseptal myocardial infarction in a 42-year-old man in the left ventricular short-axis view. A, End-diastolic cine image. B, End-systolic cine image shows a wall motion defect (arrowheads in B and C) of the anteroseptal wall; images obtained with an electrocardiographically triggered breath-hold sequence (field of view, 240 x 320 mm2; matrix, 126 x 256; 9.9/4.8; flip angle, 30°; section thickness, 8 mm). C, T1-weighted image obtained 15 minutes after administration of gadopentetate dimeglumine depicts a corresponding subendocardial late enhancement; image obtained with an inversion-recovery gradient-echo sequence (field of view, 240 x 320 mm2; matrix, 165 x 256; 7.5/3.4; inversion time, 170 msec; flip angle, 25°; section thickness, 8 mm). D-F, Three contiguous sections from 23Na MR imaging reveal elevated SI of a midventricular section in the septum and a small part of the anterior wall (arrowheads); image was obtained with an electrocardiographically triggered three-dimensional spoiled gradient-echo sequence (field of view, 450 x 450 mm2; matrix, 64 x 128; 21/3.1 msec; flip angle, 70°; section thickness, 16 mm).

 


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  		Figure 4. Graph shows percentage of infarct sizes related to left ventricular muscle mass in 15 patients after chronic myocardial infarction determined by using 23Na MR imaging, cine MR imaging, and late enhancement (LE).

 




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