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Acute myocardial infarction: serial cardiac MR imaging shows a decrease in delayed enhancement of the myocardium during the 1st week after reperfusion.

机译:急性心肌梗死:连续心脏MR成像显示再灌注后第1周延迟增强心肌的延迟增强。

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摘要

PURPOSE: To evaluate the time course of delayed gadolinium enhancement of infarcted myocardium by using serial contrast agent-enhanced (CE) cardiac magnetic resonance (MR) images obtained during the acute, subacute, and chronic stages of infarction. MATERIALS AND METHODS: The study protocol was reviewed and approved by the local ethics committee, and written informed consent was obtained. Seventeen patients with reperfused acute myocardial infarction (AMI) underwent cine and CE cardiac MR a median of 1, 7, 35, and 180 days after reperfusion. Infarct size determined on the basis of delayed enhancement MR imaging at different times was compared by using nonparametric tests and Bland-Altman analysis. Extent of myocardial enhancement was compared with single photon emission computed tomographic (SPECT) measures of infarct size with Spearman correlation. Regional myocardial enhancement extent and contractility were analyzed with nonparametric tests. RESULTS: Infarct size was 18.3% of total myocardial LV volume on day 1 after AMI and decreased to 12.9% on day 7, 11.3% on day 35, and 11.6% on day 180 (all P < .001). Estimated infarct size on day 7, as compared with day 1 enhancement size, declined by 57.1% within the epicardium and by 6.3% within the endocardium (both P < .001). Infarct size on day 7 showed only minor changes at subsequent imaging and yielded a high correlation with SPECT measurements of infarct size (r = 0.84). Infarct size on day 7 inversely correlated with long-term wall thickening (P < .0001) and allowed prediction of contractile function. CONCLUSION: In patients with AMI and successful coronary reperfusion, the size of delayed gadolinium enhancement at CE cardiac MR imaging significantly diminished during the 1st week after infarction. Thus, timing of CE cardiac MR imaging is crucial for accurate measurement of myocardial infarct size early after AMI.
机译:目的:通过使用急性,亚急性和梗死期间获得的序列造影剂增强(CE)心脏磁共振(CE)的心脏磁共振(MR)图像来评估梗死心肌的延迟钆增强的时间进程。材料和方法:研究议定书被当地伦理委员会审查并批准,并获得了书面知情同意书。 17名患者再灌注急性心肌梗死(AMI)接受了CINE和CE心脏先生,再灌注后1,7,35和180天的中位数。通过使用非参数测试和Bland-Altman分析比较在不同时间的延迟增强MR成像基础上确定的梗塞尺寸。将心肌增强程度与单次光子发射电压(SPECT)测量进行比较,具有Spearman相关性的梗塞尺寸。通过非参数测试分析了区域性心肌增强程度和收缩性。结果:在AMI之后第1天梗死大小为总心肌LV体积的18.3%,第35天的第35天减少至12.9%,第180天(全部P <.001),11.6%(所有P <.001)。与第7天的估计梗塞大小与第1天的增强尺寸相比,心外膜内的57.1%下降,内心膜内的6.3%(P <.001)。第7天的梗塞大小仅显示了随后的成像的微小变化,并与梗塞尺寸的Spect测量产生了高相关(R = 0.84)。第7天的梗塞大小与长期壁增厚(P <.0001)相关(P <.0001)并允许预测收缩功能。结论:在AMI和成功冠心再灌注患者中,CE心脏MR成像在梗死后的第1周期间CE心先生成像延迟钆增强的尺寸明显减少。因此,CE心脏MR成像的定时对于AMI后早期精确测量心肌梗塞大小的至关重要。

著录项

  • 来源
    《Radiology》 |2010年第1期|共10页
  • 作者

    Ibrahim T; Hackl T; Nekolla S;

  • 作者单位

    Department of Cardiology Klinikums Rechts der Isar and German Heart Centre Munich Munich Germany.;

  • 收录信息
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 放射医学;
  • 关键词

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