Assessment of myocardium at risk with contrast enhanced steady-state free precession cine cardiovascular magnetic resonance compared to single-photon emission computed tomography

Journal of Cardiovascular Magnetic Resonance

Research

Håkan Arheden¹  Einar Heiberg¹  John Pernow²  Peder Sörensson²  Nawsad Saleh²  Per Tornvall²  Lars Rydén²  Kenneth Caidahl³  Frederic Bouvier³ 

[1] Department of Clinical Physiology, Lund University Hospital, Lund, Sweden;Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden;Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden;

关键词: Cardiovascular Magnetic Resonance;    Infarct Size;    Late Gadolinium Enhancement;    Right Coronary Artery;    Primary Percutaneous Coronary Intervention;   

DOI  :  10.1186/1532-429X-12-25

 received in 2009-12-12, accepted in 2010-04-30,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundFinal infarct size following coronary occlusion is determined by the duration of ischemia, the size of myocardium at risk (MaR) and reperfusion injury. The reference method for determining MaR, single-photon emission computed tomography (SPECT) before reperfusion, is impractical in an acute setting. The aim of the present study was to evaluate whether MaR can be determined from the contrast enhanced myocardium using steady-state free precession (SSFP) cine cardiovascular magnetic resonance (CMR) performed one week after the acute event in ST-elevation myocardial infarction (STEMI) patients with total coronary occlusion.ResultsSixteen patients with STEMI (age 64 ± 8 years) received intravenous 99 m-Tc immediately before primary percutaneous coronary intervention. SPECT was performed within four hours. MaR was defined as the non-perfused myocardial volume derived with SPECT. CMR was performed 7.8 ± 1.2 days after the myocardial infarction using a protocol in which the contrast agent was administered before acquisition of short-axis SSFP cines. MaR was evaluated as the contrast enhanced myocardial volume in the cines by two blinded observers. MaR determined from the enhanced region on cine CMR correlated significantly with that derived with SPECT (r2 = 0.78, p < 0.001). The difference in MaR determined by CMR and SPECT was 0.5 ± 5.1% (mean ± SD). The interobserver variability of contrast enhanced cine SSFP measurements was 1.6 ± 3.7% (mean ± SD) of the left ventricle wall volume.ConclusionsContrast enhanced SSFP cine CMR performed one week after acute infarction accurately depicts MaR prior to reperfusion in STEMI patients with total occlusion undergoing primary PCI. This suggests that a single CMR examination might be performed for determination of MaR and infarct size.

【 授权许可】

Unknown   
© Sörensson et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.