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Titolo:
Magnetic resonance characterization of the peri-infarction zone of reperfused myocardial infarction with necrosis-specific and extracellular nonspecific contrast media
Autore:
Saeed, M; Lund, G; Wendland, MF; Bremerich, J; Weinmann, HJ; Higgins, CB;
Indirizzi:
Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Schering AG, Dept Radiol, D-1000 Berlin, Germany Schering AG Berlin Germany D-1000 G, Dept Radiol, D-1000 Berlin, Germany
Titolo Testata:
CIRCULATION
fascicolo: 6, volume: 103, anno: 2001,
pagine: 871 - 876
SICI:
0009-7322(20010213)103:6<871:MRCOTP>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR FUNCTION; GD-DTPA; DISTRIBUTION VOLUME; ENHANCED MRI; ECHO-PLANAR; DYSFUNCTION; SIZE; VIABILITY; ISCHEMIA; RECOVERY;
Keywords:
magnetic resonance imaging; myocardial infarction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Saeed, M Univ Calif San Francisco, Dept Radiol, 505 Parnassus Ave,L308, San Francisco, CA 94143 USA Univ Calif San Francisco 505 Parnassus Ave,L308 San Francisco CA USA 94143
Citazione:
M. Saeed et al., "Magnetic resonance characterization of the peri-infarction zone of reperfused myocardial infarction with necrosis-specific and extracellular nonspecific contrast media", CIRCULATION, 103(6), 2001, pp. 871-876

Abstract

Background-Because ischemically injured myocardium is frequently composed of viable and nonviable portions, a method to discriminate the two is useful for clinical management. Methods and Results-Ischemically injured myocardium was characterized withextracellular nonspecific (Gd-DTPA) and necrosis-specific (mesoporphyrin) MR contrast media in rats. Relaxation rates (R1) were measured on day 1 andday 2 by inversion-recovery echoplanar imaging, Spin-echo imaging was usedto define contrast-enhanced regions and regional wall thickening. Gadolinium concentration, area at risk, and infarct size were measured at postmortem examination, Delta R1 ratio (Delta R1(myocardium)/Delta R1(blood)) after administration of Gd-DTPA was greater in ischemically injured myocardium (1.20+/-0.15) than in normal myocardium (0.47+/-0.05, P<0.05), which was attributed to differences in gadolinium concentration and water content. The Gd-DTPA-enhanced region on day 2 was larger (32.8+/-0.9%) than true infarction as demonstrated by triphenyltetrazolium chloride (TTC) (24.6+/-1.4%, P<0.001, r=0.21), Bland-Altman analysis revealed that the Gd-DTPA-enhanced region overestimated true infarct size by 7.8+/-5.9%. On the other hand, the mesoporphyrin-enhanced region (26.9+/-1.8%, P=NS, r=0.87) and true infarct size were identical, The difference in the areas demarcated by the 2 agents is the peri-infarction. Systolic and diastolic MR images revealed no wall thickening in the mesoporphyrin-enhanced region (0.3+/-3.3%) but reduced thickening in the Gd-DTPA-enhanced rim (8.5+/-5.5%, P<0.05). Conclusions-The Gd-DTPA-enhanced region encompasses both viable and nonviable portions of the ischemically injured myocardium. The Gd-DTPA-enhanced area overestimated infarct size, but the mesoporphyrin-enhanced area matchedtrue infarct size, The salvageable peri-infarction zone can be characterized with double-contrast-enhanced and functional MR imaging; the mismatched area of enhancement between the 2 agents shows residual wall thickening.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 21:46:03