3D and 2D delayed-enhancement magnetic resonance imaging for detection of myocardial infarction: preclinical and clinical results.

RATIONALE AND OBJECTIVES The purpose was to verify whether myocardial viability can be detected by a delayed enhancement magnetic resonance imaging (MRI) approach using a rapid three-dimensional inversion-recovery fast low-angle shot (3D IR-FLASH) sequence in a preclinical and clinical setting. MATERIALS AND METHODS Nonreperfused myocardial infarctions were induced in eight minipigs. Both the pigs and 15 patients with suspected myocardial infarction underwent MRI using a rapid 3D IR-FLASH sequence and a two-dimensional IR-FLASH sequence as the reference standard. RESULTS In the pigs, a total of 52 segments with myocardial infarction were identified with both sequences and there was good agreement in transmurality of 99.5%. The infarction volume determined with the 3D IR-FLASH in the animal study (2.4 +/- 1.5 cm(3)) showed a good correlation with the histomorphometrically determined volume using triphenyltetrazolium chloride (2.3 +/- 1.2 cm(3), r = 0.98, P < .001) and the two-dimensional IR-FLASH sequence (2.3 +/- 1.4 cm(3), r = 0.99, P < .001). Eleven of 15 patients were found to have myocardial infarction in 37 myocardial segments with both sequences and there was a good agreement in transmurality of 98.8%. There was also a good correlation in the clinical study between the 3D and 2D sequences (6.9 +/- 6.7 cm(3) vs. 6.8 +/- 6.5 cm(3), r = 0.98, P < .001). In Bland-Altman analysis there was no significant under- or overestimation of the myocardial infarction volume using the 3D IR-FLASH sequence in comparison to the two-dimensional reference standard in both the preclinical and clinical study. The contrast-to-noise ratios were not significantly different between 3D and 2D sequences in the animal (34.7 +/- 1.5 vs. 33.8 +/- 2.6; P = .51) and clinical study (31.4 +/- 12.5 vs. 36.7 +/- 11.5; P = .31). The breathhold time for the 3D IR-FLASH sequence in the clinical study (20.4 +/- 2.2 s) was significantly shorter than that of the 2D IR-FLASH sequence (190.1 +/- 20.8 s, P < .001). CONCLUSIONS The rapid 3D IR-FLASH sequence detects myocardial infarction with high accuracy and allows a relevant reduction in acquisition time.

[1]  Bernd Hamm,et al.  Magnetic Resonance Imaging of Myocardial Perfusion and Viability Using a Blood Pool Contrast Agent , 2004, Investigative radiology.

[2]  D. Levy,et al.  Temporal Trends in Coronary Heart Disease Mortality and Sudden Cardiac Death From 1950 to 1999: The Framingham Heart Study , 2004, Circulation.

[3]  R. Kim,et al.  Contrast-enhanced MRI and routine single photon emission computed tomography (SPECT) perfusion imaging for detection of subendocardial myocardial infarcts: an imaging study , 2003, The Lancet.

[4]  Wolfgang Ebert,et al.  Imaging of myocardial infarction: comparison of magnevist and gadophrin-3 in rabbits. , 2002, Journal of the American College of Cardiology.

[5]  E. McVeigh,et al.  Phase‐sensitive inversion recovery for detecting myocardial infarction using gadolinium‐delayed hyperenhancement † , 2002, Magnetic resonance in medicine.

[6]  A. Beek,et al.  Myocardial viability: rapid assessment with delayed contrast-enhanced MR imaging with three-dimensional inversion-recovery prepared pulse sequence. , 2004, Radiology.

[7]  A. Beckett,et al.  AKUFO AND IBARAPA. , 1965, Lancet.

[8]  R. Kim,et al.  Late gadolinium cardiovascular magnetic resonance in the assessment of myocardial viability. , 2005, Coronary artery disease.

[9]  Andrew C Larson,et al.  Motion‐corrected free‐breathing delayed enhancement imaging of myocardial infarction , 2005, Magnetic resonance in medicine.

[10]  O. Simonetti,et al.  The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. , 2000, The New England journal of medicine.

[11]  Bernd Hamm,et al.  Myocardial viability: assessment with three-dimensional MR imaging in pigs and patients. , 2006, Radiology.

[12]  O. Simonetti,et al.  An improved MR imaging technique for the visualization of myocardial infarction. , 2001, Radiology.

[13]  Katherine C. Wu,et al.  Myocardial viability: breath-hold 3D MR imaging of delayed hyperenhancement with variable sampling in time. , 2004, Radiology.

[14]  Jeroen J. Bax,et al.  Quantification of myocardial infarct size and transmurality by contrast-enhanced magnetic resonance imaging in men. , 2004, The American journal of cardiology.

[15]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[16]  Three‐dimensional magnetic resonance imaging technique for myocardial‐delayed hyperenhancement: A comparison with the two‐dimensional technique , 2004, Journal of magnetic resonance imaging : JMRI.

[17]  S. Schoenberg,et al.  Single-shot inversion recovery TrueFISP for assessment of myocardial infarction. , 2006, AJR. American journal of roentgenology.

[18]  A. Demirci,et al.  Low-dose gadobenate dimeglumine versus standard-dose gadopentate dimeglumine for delayed contrast-enhanced cardiac magnetic resonance imaging. , 2006, Academic radiology.

[19]  S. Schoenberg,et al.  Single breath-hold real-time cine MR imaging: improved temporal resolution using generalized autocalibrating partially parallel acquisition (GRAPPA) algorithm , 2003, European Radiology.

[20]  M. Cerqueira,et al.  Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. , 2002, Circulation.