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Clinically Unrecognized Myocardial Infarction Detected at MR Imaging May Not Be Associated with Atherosclerosis¹

¹ From the Departments of Radiology (C.E.B., T.B., T.H., L.J., H.A.) and Medicine (J.A., L.L.), Uppsala University Hospital, 751 85 Uppsala, Sweden; and AstraZeneca, Gothenburg, Sweden (L.L., J.H., L.J.). From the 2006 RSNA Annual Meeting. Received September 26, 2006; revision requested December 5; revision received December 7; accepted January 15, 2007; final version accepted March 14. Supported by the Swedish Research Council, grant no. K2006-71X-06676-21-3, and the Linné Foundation for Medical Research, Uppsala, Sweden. Address correspondence to C.E.B. (e-mail: Charlotte.Ebeling_Barbier{at}radiol.uu.se).

View larger version (18K): [in this window] [in a new window] [Download PPT slide]   Figure 1: Diagram of left ventricle divided into 17 segments in accordance with American Heart Association segmentation system (26). Shadowed segments represent region where 42 (86%) of 49 UMIs were located.

View larger version (18K): [in this window] [in a new window] [Download PPT slide]   Figure 2: Graph of prevalence of significant atherosclerosis (ie, luminal narrowing exceeding 50%) in any vessel at whole-body MR angiography in subjects without MI scars on cardiac MR images (No MI), those with UMI, and those with RMI.

View larger version (58K): [in this window] [in a new window] [Download PPT slide]   Figure 3: Left: Anteroposterior maximum intensity projection of whole-body MR angiogram (repetition time msec/echo time msec, 2.5/0.94; flip angle, 30°; acquired voxel size, 1.76 x 1.76 x 4.0 mm reconstructed to 0.88 x 0.88 x 2.0 mm) shows significant atherosclerosis in left anterior tibial artery (arrow). Right: Cardiac late-enhancement MR images (approximately 3.6 [shortest]/approximately 1.8 [shortest]; flip angle, 15°; acquired voxel size, 1.56 x 2.81 x 10 mm reconstructed to 1.56 x 1.56 x 5 mm; individually set inversion time) in same subject demonstrate RMI (arrows) in free lateral wall of left ventricle.

View larger version (13K): [in this window] [in a new window] [Download PPT slide]   Figure 4a: Graphs of differences in (a) intima-media thickness (IMT), (b) C-reactive protein level (CRP), and (c) Framingham risk score between subjects without MI scars on cardiac MR images (No MI), those with UMI, and those with RMI. * = P < .0167 (ie, .05 with Bonferroni correction).

View larger version (13K): [in this window] [in a new window] [Download PPT slide]   Figure 4b: Graphs of differences in (a) intima-media thickness (IMT), (b) C-reactive protein level (CRP), and (c) Framingham risk score between subjects without MI scars on cardiac MR images (No MI), those with UMI, and those with RMI. * = P < .0167 (ie, .05 with Bonferroni correction).

View larger version (19K): [in this window] [in a new window] [Download PPT slide]   Figure 4c: Graphs of differences in (a) intima-media thickness (IMT), (b) C-reactive protein level (CRP), and (c) Framingham risk score between subjects without MI scars on cardiac MR images (No MI), those with UMI, and those with RMI. * = P < .0167 (ie, .05 with Bonferroni correction).