Reperfusion and irreversible myocardial injury: identification with a nonionic MR imaging contrast medium

The potential of a new nonionic gadolinium complex--gadodiamide injection--to (a) allow distinction between reperfused and occlusive infarction and (b) enable differentiation between reperfused reversible and irreversible myocardial injury was investigated. Three groups of rats were used: 10 with reversibly reperfused myocardial injury, 10 with irreversibly reperfused injury, and 10 with occlusive infarction. Before administration of contrast material, there was no significant difference in signal intensity between normal and injured regions on T1-weighted images. After administration of gadodiamide injection (0.2 mmol/kg), the reversibly injured myocardium was indistinguishable from normal myocardium, while the reperfused irreversibly injured zone showed prominent and homogeneous enhancement. Occlusive infarcts showed three zones of differential enhancement consisting of normal, periinfarction, and infarction regions. Gadodiamide injection provides differential enhancement in reversibly reperfused, irreversibly reperfused, and occlusive infarcts. Thus, it may be useful as a marker of reperfusion and extent of infarction after thrombolytic therapy.