Summary
Magnetic resonance imaging (MRI) is a noninvasive and specific method for production of high resolution tomographic images in blocks of three-dimensional information. Apart from scintigraphic techniques and computed tomography for the evaluation of myocardial ischemia and infarcts, MRI has emerged as a new diagnostic technique to study the extent of anatomical and functional abnormalities in patients with coronary artery disease. Conventional noncontrast MRI can identify acutely infarcted myocardial areas, although the difficulty in identifying myocardial ischemia and infarcts with noncontrast MRI suggests a potential role for contrast enhanced MRI. The use of the paramagnetic contrast agent gadolinium (Gd)-diethylene triamine pentaacetic acid (DTPA) improves depiction of infarcted myocardium on Tl-weighted spin-echo MR images that are obtained soon after acute myocardial infarction. This is of particular interest for the estimation of myocardial infarct size. Furthermore, ultrafast subsecond imaging, in combination with Gd-DTPA, offers the potential to analyze cardiac first pass and myocardial perfusion. The development of nontoxic paramagnetic contrast agents which are selectively taken up by viable myocardium would be helpful in assessing the presence of ischemic/infarcted myocardium and myocardial salvage by MRI following reperfusion.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Tscholakoff D, Higgins CB, McNamara MT, Derugin N. Early-phase myocardial infarction: evaluation by MR imaging. Radiology 1986; 159: 667–2.
Ratner AV, Okada RD, Newell JB, Pohost GM. The relationship between proton nuclear magnetic resonance relaxation parameters and myocardial perfusion with acute coronary arterial occlusion and reperfusion. Circulation 1985; 71: 823–8.
Pflugfelder PW, Wisenberg G, Prato FS, Carroll SE, Turner KL. Early detection of canine myocardial infarction by magnetic resonance imaging in vivo. Circulation 1985; 71: 587–94.
Tscholakoff D, Higgins CB, Sechtem U, Caputo G, Derugin N. MRI of reperfused myocardial infarct in dogs. AJR Am J Roentgenol 1986; 146: 925–30.
Bouchard A, Reeves RC, Cranney G, Bishop SO, Pohost GM, Bischoff P. Assessment of myocardial infarct size by means of T2-weighted 1H nuclear magnetic resonance imaging. Am Heart J 1989; 117: 281–9.
Wisenberg G, Prato FS, Carroll SE, Turner KL, Marshall T. Serial nuclear magnetic resonance imaging of acute myocardial infarction with and without reperfusion. Am Heart J 1988; 115: 510–8.
Caputo GR, Sechtem U, Tscholakoff D, Higgins CB. Measurements of myocardial infarct size at early and late time intervals using MR imaging: an experimental study in dogs. AJR Am J Roentgenol 1987; 149: 237–43.
McNamara MT, Higgins CB, Schechtmann N et al. Detection and characterization of acute myocardial infarction in man with the use of gated magnetic resonance. Circulation 1985; 71: 717–24.
Johnston DL, Thompson RC, Liu P et al. Magnetic resonance imaging during acute myocardial infarction. Am J Cardiol 1986; 57: 1059–65.
Fisher MR, McNamara MT, Higgins CB. Acute myocardial infarction: MR evaluation in 29 patients. AJR Am J Roentgenol 1987; 148: 247–51.
Ahmad M, Johnson RF Jr, Fawcett HD, Schreibert MH. Magnetic resonance imaging in patients with unstable angina: comparison with acute myocardial infarction and normals. Magn Reson Imaging 1988; 6: 527–34.
Been M, Smith MA, Ridgeway JP et al. Characterisation of acute myocardial infarction by gated magnetic resonance imaging. Lancet 1985; 2: 348–50.
Been M, Smith MA, Ridgeway JP et al. Serial changes in the T1 magnetic relaxation parameter after myocardial inafarction in man. Br Heart J 1988; 59: 1–8.
Filipchuk NG, Peshock RM, Malloy GR et al. Detection and localization of recent myocardial infarction by magnetic resonance imaging. Am J Cardiol 1986; 58: 214–9.
Krauss XH, Van der Wall EE, Doornbos J et al. The value of nuclear magnetic resonance imaging in patients with a recent myocardial infarction: comparison with planar thallium-201 scintigraphy. Cardiovasc Intervent Radiol 1989; 12: 119–24.
Krauss XH, Van der Wall EE, Van der Laarse A et al. Follow-up of regional myocardial T2 relaxation times in patients with myocardial infarction evaluated with magnetic resonance imaging. Eur J Radiol 1990; 11: 110–9.
Wisenberg G, Finnie KJ, Jablonsky G, Kostuk WJ, Marshall T. Nuclear magnetic resonance and radionuclide angiographic assessment of acute myocardial infarction in a randomized trial of intravenous streptokinase. Am J Cardiol 1988; 62: 1011–6.
White RD, Cassidy MM, Melvin MD et al. Segmental evaluation of left ventricular wall motion after myocardial infarction: magnetic resonance imaging versus echocardiography. Am Heart J 1988; 115: 166–75.
Brown JJ, Higgins CB. Myocardial paramagnetic contrast agents for MR imaging. AJR Am J Roentgenol 1988; 151: 865–72.
Young SW. Magnetic resonance imaging: basic principles. 2nd ed. New York: Raven Press, 1988: 98–100.
Atkinson DJ, Burstein D, Edelman RR. First-pass cardiac perfusion: evaluation with ultrafast MR imaging. Radiology 1990; 174: 757–62.
Goldman MR, Brady TJ, Pykett IL et al. Quantification of experimental myocardial infarction using nuclear magnetic resonance imaging and paramagnetic ion contrast enhancement in excised canine hearts. Circulation 1982; 66: 1012–6.
Arvelo P. Toxicity of rare-earths. Prog Pharmacol 1979; 2: 262–8.
Lauffer RB. Magnetic resonance contrast media: principles and progress. Magn Reson Q 1990; 6: 65–84.
Engelstad BL, Wolf GL. Contrast agents.In: Stark DD, Bradley WG Jr, editors. Magnetic resonance imaging. St. Louis: Mosby, 1988: 161–81.
Slutsky RA, Peterson T, Strich G, Brown JJ. Hemodynamic effects of rapid and slow infusions of manganese chloride and gadolinium-DTPA in dogs. Radiology 1985; 154: 733–5.
Brasch RC, Weinmann HJ, Wesbey GE. Contrast-enhanced NMR imaging: animal studies using gadolinium-DTPA complex. AJR Am J Roentgenol 1984; 142: 625–30.
Strich G, Hagan PL, Gerber KH, Slutsky RA. Tissue distribution and magnetic resonance spin lattice relaxation effects of gadolinium-DTPA. Radiology 1985; 154: 723–6.
Niendorf HP, Dinger JC, Haustein J, Cornelius I, Alhassan A, Clauss W. Tolerance data of Gd-DTPA: a review. Eur J Radiol 1991; 13: 15–20.
Weiss KL, Jhaveri HS. Severe anaphylactoid reaction after IV Gd-DTPA [abstract]. Magn Reson Imaging 1990; 8 suppl 1: 81.
Holman ER, Van Dijkman PRM, Van der Wall EE et al. Assessment of myocardial perfusion during ischemia and reperfusion in isolated rat hearts using Gadolinium-DTPA enhanced magnetic resonance imaging. Coronary Artery Dis 1991; 2: 789–98.
McNamara MT, Higgins CB, Ehman RL, Revel D, Sievers R, Brasch RC. Acute myocardial ischemia: magnetic resonance contrast enhancement with gadolinium-DTPA. Radiology 1984; 153: 157–63.
Johnston DL, Liu P, Lauffer RB et al. Use of gadolinium-DTPA as a myocardial perfusion agent: potential applications and limitations for magnetic resonance imaging. J Nucl Med 1987; 28: 871–7.
Miller DD, Holmvang G, Gill JB et al. MRI detection of myocardial perfusion changes by gadolinium-DTPA infusion during dipyridamole hyperemia. Magn Reson Med 1989; 10: 246–55.
Van Rugge FP, Boreel JJ, Van der Wall EE et al. Assessment of cardiac first-pass and myocardial perfusion in normal subjects using Gadolinium-DTPA enhanced subsecond magnetic resonance imaging. J Comput Assist Tomogr 1991; 15: 959–65.
Rehr RB, Peshock RM, Malloy CR et al. Improved in vivo magnetic resonance imaging of acute myocardial infarction after intravenous paramagnetic contrast agent administration. Am J Cardiol 1986; 57: 864–8.
Matheijssen NAA, De Roos A, Van der Wall EE et al. Acute myocardial infarction: comparison of T2-weighted and Tl-weighted gadolinium-DTPA enhanced MR imaging. Magn Reson Med 1991; 17: 460–9.
Eichstaedt HW, Felix R, Dougherty FC, Langer M, Rusch W, Schmutzler H. Magnetic resonance imaging (MRI) in different stages of myocardial infarction using the contrast agent gadolinium-DTPA. Clin Cardiol 1986; 9: 527–35.
De Roos A, Doornbos J, Van der Wall EE, Van Voorthuisen AE. MR imaging of acute myocardial infarction: value of Gd-DTPA. AJR Am J Roentgenol 1988; 150: 531–4.
Van Dijkman PRM, Doornbos J, De Roos A et al. Improved detection of acute myocardial infarction by magnetic resonance imaging using gadolinium-DTPA1. Int J Card Imaging 1989; 5: 1–8.
Van der Wall EE, Van Dijkman PRM, De Roos A et al. Diagnostic significance of gadolinium-DTPA (diethylenetriamine penta-acetic acid) enhanced magnetic resonance imaging in thrombolytic therapy for acute myocardial infarction: its potential in assessing reperfusion. Br Heart J 1990; 63: 12–7.
Nishimura T, Kobayashi H, Ohara Y et al. Serial assessment of myocardial infarction by using gated MR imaging and Gd-DTPA. AJR Am J Roentgenol 1989; 153: 715–20.
Van Dijkman PRM, Van der Wall EE, De Roos A et al. Acute, subacute and chronic myocardial infarction: quantitative analysis of gadolinium-enhanced MR images. Radiology 1991; 180: 147–51.
Johnston DL, Brady TJ, Ratner AV et al. Assessment of myocardial ischemia with proton magnetic resonance: effects of three hour coronary occlusion with and without reperfusion. Circulation 1985; 71: 595–601.
Tscholakoff D, Higgins CB, Sechtem U, McNamara MT. Occlusive and reperfused myocardial infarcts: effect of Gd-DTPA on ECG-gated MR imaging. Radiology 1986; 160: 515–9.
Aisen AM, Buda AJ, Zotz RJ, Buckwalter KA. Visualization of myocardial infarction and subsequent coronary reperfusion with MRI using a dog model. Magn Reson Imaging 1987; 5: 399–404.
Peshock RM, Malloy CR, Buja LM, Nunnally RL, Parkey RW, Willerson JT. Magnetic resonance imaging of acute myocardial infarction: gadolinium diethylenetriamine pentaacetic acid as a marker of reperfusion. Circulation 1986; 74: 1434–40.
Schaefer S, Malloy CR, Katz J et al. Gadolinium-DTPA enhanced nuclear magnetic resonance imaging of reperfused myocardium: identification of the myocardial bed at risk. J Am Coll Cardiol 1988; 12: 1064–72.
McNamara MT, Tscholakoff D, Revel D et al. Differentiation of reversible and irreversible myocardial injury by MR imaging with and without gadolinium-DTPA. Radiology 1986; 158: 765–9.
Van Rossum AC, Visser FC, Van Eenige MJ et al. Value of gadolinium-diethylene-triamine pentaacetic acid dynamics in magnetic resonance imaging of acute myocardial infarction with occluded and reperfused coronary arteries after thrombolysis. Am J Cardiol 1990; 65:845–51.
De Roos A, Van Rossum AC, Van der Wall EE et al. Reperfused and nonreperfused myocardial infarction: diagnostic potential of Gd-DTPA-enhanced MR imaging. Radiology 1989; 172: 717–20.
De Roos A, Matheijssen NAA, Doornbos J, Van Dijkman PRM, Van Voorthuisen AE, Van der Wall EE. Myocardial infarct size after reperfusion therapy: assessment with Gd-DTPA-enhanced MR imaging. Radiology 1990; 176: 517–21.
Van Dijkman PRM, De Roos A, Van der Wall EE et al. Reduction of infarct size after thrombolytic therapy by Gadolinium-DTPA enhanced magnetic resonance imaging.In: Schmidt HA, Van der Schoot JB, editors. Nuclear medicine: the state of the art of nuclear medicine in Europe. Stuttgart: Schattauer, 1991: 68–70.
Schmiedl U, Ogan MD, Moseley ME, Brasch RC. Comparison of the contrast-enhancing properties of albumin-(Gd-DTPA) and Gd-DTPA at 2.0 T: an experimental study in rats. AJR Am J Roentgenol 1986; 147:1263–70.
Schmiedl U, Moseley ME, Sievers R et al. Magnetic resonance imaging of myocardial infarction using albumin-(Gd-DTPA), a macromolecular blood-volume contrast agent in a rat model. Invest Radiol 1987; 22: 713–21.
Saeed M, Wendland MF, Masui T et al. Myocardial infarction: assessment with an intravascular MR contrast medium. Radiology 1991; 180: 153–60.
Van Dijkman PRM, Höld KM, Van der Laarse A et al. Sequential analysis of infarcted and normal myocardium in pigs using in vivo Gadolinium-DTPA enhanced magnetic resonance imaging. Magn Reson Imaging (In press).
Wolf GL. Role of magnetic resonance contrast agents in cardiac imaging. Am J Cardiol 1990; 66: 59F–62F.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1992 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
van Dijkman, P.R.M., van der Wall, E.E. (1992). Magnetic resonance imaging using paramagnetic contrast agents in the clinical evaluation of myocardial infarction. In: van der Wall, E.E., Sochor, H., Righetti, A., Niemeyer, M.G. (eds) What’s New in Cardiac Imaging?. Developments in Cardiovascular Medicine, vol 133. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-2456-0_15
Download citation
DOI: https://doi.org/10.1007/978-94-011-2456-0_15
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-010-5083-8
Online ISBN: 978-94-011-2456-0
eBook Packages: Springer Book Archive