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Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function

R J Kim1, D S Fieno, T B Parrish

  • 1Northwestern University Medical School, Feinberg Cardiovascular Research Institute, Department of Medicine, Chicago, IL 60611-3008, USA.

Circulation
|November 11, 1999
PubMed
Abstract

Insights

Contrast MRI can differentiate between temporary and permanent heart damage. This technique accurately identifies myocardial infarction (MI) and reversible ischemic injury, regardless of wall motion or age.

Area of Science:

  • Cardiovascular Imaging
  • Magnetic Resonance Imaging
  • Myocardial Pathophysiology

Background:

  • Contrast-enhanced MRI patterns in ischemic myocardial injury are not well-established.
  • Investigating enhancement patterns in acute infarction (AI), reversible ischemic injury (RII), and chronic infarction.

Purpose of the Study:

  • To compare contrast MRI enhancement patterns in AI, RII, and chronic infarction.
  • To determine if MRI can distinguish between reversible and irreversible ischemic myocardial injury.

Main Methods:

  • Utilized canine models to induce AI/chronic infarction and RII.
  • Acquired cine MRI and Gd-DTPA-enhanced MR images at various time points.
  • Correlated MRI findings with histological assessments of myocyte necrosis and collagenous scar.

Main Results:

  • AI showed significant hyperenhancement (294% of normal) compared to normal myocardium.
  • RII did not exhibit hyperenhancement (98% of normal) after reperfusion.
  • Hyperenhancement extent correlated strongly with myocyte necrosis and scar formation (R > 0.97).

Conclusions:

  • Contrast MRI effectively distinguishes between reversible and irreversible ischemic myocardial injury.
  • MRI findings are independent of wall motion abnormalities and infarct age.
  • This technique offers valuable diagnostic information for ischemic heart disease.

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