Detection of a silent myocardial infarction with phosphor-31 two-dimensional chemical shift imaging (31P 2-D CSI)

Phosphor-31 two-dimensional chemical shift imaging (3lP 2-D CSI) is a well-established noninvasive technique in experimental research on regional myocardial ischemia, and it permits in vivo monitoring of high-energy phosphate metabolism in the myocardium without requiring external tracers,wherein phosphocreatinine (PCr) and beta-adenosine triphosphate (beta-ATP) are the main components of investigation. The decrease of PCr is one of the earliest reactions to acute myocardial ischemia, but also fixed defects after myocardial infarction (MI) showed a reduced ratio of PCr/beta-ATP, probably because of are modeling process taking place in the noninfarcted tissue.

A 55-year-old patient with diabetes mellitus type 1 is reported, who presented within the scope of a study at the University Hospital Innsbruck, Austria, and in whom 31P 2-D CSI helped to detect a so far unknown coronary heart disease (CHD).

In the presented case, 31P 2-D CSI for the first time helped to reveal a severe CHD and a so far unknown MI,and and if the calculated voxel size was chosen small enough, even a satisfying localization of the lesion became possible.