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Functional Neuroimaging Using Ultrasonic Blood-brain Barrier Disruption and Manganese-enhanced MRI
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Manganese-Enhanced T1 Mapping in the Myocardium of Normal and Infarcted Hearts
N B Spath1, D M L Lilburn2, G A Gray1
1British Heart Foundation Centre of Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
Contrast Media & Molecular Imaging
|December 1, 2018
Summary
Manganese-enhanced MRI (MEMRI) accurately assesses infarct size and myocardial calcium handling. This technique shows promise for evaluating heart viability, remodeling, and regeneration after infarction.
Area of Science:
- Cardiovascular Imaging
- Magnetic Resonance Imaging
- Biomedical Engineering
Background:
- Manganese-enhanced MRI (MEMRI) offers potential for assessing myocardial viability and calcium handling.
- Two clinical manganese contrast agents, mangafodipir (chelated) and EVP1001-1 (nonchelated), mitigate risks associated with calcium-channel agonism.
- This study investigates chelated and nonchelated manganese agents, their myocardial uptake mechanisms, and application in infarcted hearts using T1 mapping.
Purpose of the Study:
- To explore the mechanisms of myocardial uptake for chelated and nonchelated manganese contrast agents.
- To evaluate the application of MEMRI with T1 mapping in infarcted hearts.
- To compare the accuracy of MEMRI with traditional gadolinium-enhanced MRI techniques for infarct size assessment.
Main Methods:
- T1 mapping was performed in rats using 7T MRI before and after administration of chelated or nonchelated manganese contrast agents, with or without calcium channel blockade.
- Myocardial infarction was induced in a separate cohort of rats, followed by imaging with gadolinium-enhanced MRI (DEMRI) and MEMRI T1 mapping.
- Infarct size was quantified histologically using Masson's trichrome staining at 12 weeks post-infarction.
Main Results:
- Both manganese agents caused concentration-dependent myocardial T1 shortening, most pronounced with nonchelated manganese and partially inhibited by calcium channel blockade.
- MEMRI T1 mapping demonstrated good agreement with histological infarct size, outperforming DEMRI techniques in accuracy.
- Increased manganese uptake in remote myocardium correlated inversely with left ventricular ejection fraction, suggesting altered calcium handling.
Conclusions:
- MEMRI-induced myocardial T1 shortening is concentration and calcium channel-dependent.
- MEMRI with T1 mapping accurately assesses infarct size and detects changes in remote myocardial calcium handling.
- This technique holds significant potential for evaluating myocardial viability, remodeling, and regeneration.
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