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January 1, 2001Radiology1,354 citations

An Improved MR Imaging Technique for the Visualization of Myocardial Infarction

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OSOrlando P. SimonettiCardiac ImagingRKRaymond J. KimDFDavid S. FienoCardiovascular Medical Group

Structured PICO

Does segmented inversion-recovery turboFLASH MR imaging improve the visualization of myocardial infarction compared to other MR sequences in dogs and patients with coronary artery disease?

P
Population
6 dogs with induced ischemic injury and 18 patients with coronary artery disease and myocardial infarction
I
Intervention
Segmented inversion-recovery turbo fast low-angle shot (turboFLASH) magnetic resonance (MR) imaging pulse sequence (contrast-enhanced)
C
Comparator
Other MR imaging approaches (10 different pulse sequences tested in dogs)
O
Outcome
Signal intensity difference between infarcted and normal myocardiumsurrogate

The segmented inversion-recovery turboFLASH MR imaging sequence substantially improves the differentiation between infarcted and normal myocardium.

Abstract

PURPOSE: To design a segmented inversion-recovery turbo fast low-angle shot (turboFLASH) magnetic resonance (MR) imaging pulse sequence for the visualization of myocardial infarction, compare this technique with other MR imaging approaches in a canine model of ischemic injury, and evaluate its utility in patients with coronary artery disease. MATERIALS AND METHODS: Six dogs and 18 patients were examined. In dogs, infarction was produced and images were acquired by using 10 different pulse sequences. In patients, the segmented turboFLASH technique was used to acquire contrast material-enhanced images 19 days +/- 7 (SD) after myocardial infarction. RESULTS: Myocardial regions of increased signal intensity were observed in all animals and patients at imaging. With the postcontrast segmented turboFLASH sequence, the signal intensity of the infarcted myocardium was 1,080% +/- 214 higher than that of the normal myocardium in dogs-nearly twice that of the next best sequence tested and approximately 10-fold greater than that in previous reports. All 18 patients with myocardial infarction demonstrated high signal intensity at imaging. On average, the signal intensity of the high-signal-intensity regions in patients was 485% +/- 43 higher than that of the normal myocardium. CONCLUSION: The segmented inversion-recovery turboFLASH sequence produced the greatest differences in regional myocardial signal intensity in animals. Application of this technique in patients with infarction substantially improved differentiation between injured and normal regions.

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Simonetti et al. (2001) studied this question.

synapsesocial.com/papers/69f14b852811130d0cde21f4https://doi.org/10.1148/radiology.218.1.r01ja50215
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