Gadolinium-DTPA-enhanced nuclear magnetic resonance imaging of reperfused myocardium

Identification of the myocardial bed at risk

Saul Schaefer, Craig R. Malloy, Jose Katz, Robert W. Parkey, L. Maximilian Buja, James T. Willerson, Ronald M. Peshock

Research output: Contribution to journalArticle

114 Citations (Scopus)

Abstract

Gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA)-enhanced nuclear magnetic resonance (NMR) imaging can be useful in the identification of reperfused myocardium. However, the effects of dose and the time of administration and the relation of the extent of the region of enhancement to the myocardial bed at risk have not been evaluated. In this study, dogs were given Gd-DTPA (0.1 mM/kg body weight [n = 21] or 0.34 mM/kg [n = 7]) or saline solution (n = 5) after various periods of occlusion and reperfusion. Twenty-five dogs were killed after 1 or 2 h of reperfusion and the excised hearts were imaged. Images were analyzed for presence, intensity and extent of a region of increased signal. All images in dogs given Gd-DTPA had easily identifiable regions of increased signal in the distribution of the reperfused myocardial bed. Analysis of the extent of these regions in spin-echo images of excised hearts when Gd-DTPA was administered after 5 min of reperfusion demonstrated a correlation coefficient of 0.72 with the bed at risk as determined postmortem with a dye perfusion technique. These images consistently overestimated the infarct size. Signal intensity of the reperfused myocardium increased to a maximum of 1.67 times control (p < 0.05) in spin-lattice relaxation time (T1)-weighted sequences as the dose of Gd-DTPA increased. This was due to a higher concentration of Gd-DTPA in the reperfused myocardium with resultant shortening of the T1 relaxation time. When Gd-DTPA was given after 90 min of reperfusion, NMR images did not identify the bed at risk. In dogs not given Gd-DTPA, there was no significant correlation between the region of increased signal intensity and the bed at risk. Thus, administration of Gd-DTPA early in reperfusion allows identification of the anatomic bed at risk in T1-weighted NMR images.

Original languageEnglish (US)
Pages (from-to)1064-1072
Number of pages9
JournalJournal of the American College of Cardiology
Volume12
Issue number4
DOIs
StatePublished - 1988
Externally publishedYes

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Pentetic Acid
Gadolinium DTPA
Gadolinium
Myocardium
Magnetic Resonance Spectroscopy
Magnetic Resonance Imaging
Reperfusion
Dogs
Sodium Chloride
Coloring Agents
Perfusion
Body Weight

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Gadolinium-DTPA-enhanced nuclear magnetic resonance imaging of reperfused myocardium : Identification of the myocardial bed at risk. / Schaefer, Saul; Malloy, Craig R.; Katz, Jose; Parkey, Robert W.; Buja, L. Maximilian; Willerson, James T.; Peshock, Ronald M.

In: Journal of the American College of Cardiology, Vol. 12, No. 4, 1988, p. 1064-1072.

Research output: Contribution to journalArticle

Schaefer, Saul ; Malloy, Craig R. ; Katz, Jose ; Parkey, Robert W. ; Buja, L. Maximilian ; Willerson, James T. ; Peshock, Ronald M. / Gadolinium-DTPA-enhanced nuclear magnetic resonance imaging of reperfused myocardium : Identification of the myocardial bed at risk. In: Journal of the American College of Cardiology. 1988 ; Vol. 12, No. 4. pp. 1064-1072.
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abstract = "Gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA)-enhanced nuclear magnetic resonance (NMR) imaging can be useful in the identification of reperfused myocardium. However, the effects of dose and the time of administration and the relation of the extent of the region of enhancement to the myocardial bed at risk have not been evaluated. In this study, dogs were given Gd-DTPA (0.1 mM/kg body weight [n = 21] or 0.34 mM/kg [n = 7]) or saline solution (n = 5) after various periods of occlusion and reperfusion. Twenty-five dogs were killed after 1 or 2 h of reperfusion and the excised hearts were imaged. Images were analyzed for presence, intensity and extent of a region of increased signal. All images in dogs given Gd-DTPA had easily identifiable regions of increased signal in the distribution of the reperfused myocardial bed. Analysis of the extent of these regions in spin-echo images of excised hearts when Gd-DTPA was administered after 5 min of reperfusion demonstrated a correlation coefficient of 0.72 with the bed at risk as determined postmortem with a dye perfusion technique. These images consistently overestimated the infarct size. Signal intensity of the reperfused myocardium increased to a maximum of 1.67 times control (p < 0.05) in spin-lattice relaxation time (T1)-weighted sequences as the dose of Gd-DTPA increased. This was due to a higher concentration of Gd-DTPA in the reperfused myocardium with resultant shortening of the T1 relaxation time. When Gd-DTPA was given after 90 min of reperfusion, NMR images did not identify the bed at risk. In dogs not given Gd-DTPA, there was no significant correlation between the region of increased signal intensity and the bed at risk. Thus, administration of Gd-DTPA early in reperfusion allows identification of the anatomic bed at risk in T1-weighted NMR images.",
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AU - Buja, L. Maximilian

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