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- Document type:
- Journal Article; Article
- Author(s):
- Klein, C; Schmal, TR; Nekolla, SG; Schnackenburg, B; Fleck, E; Nagel, E
- Title:
- Mechanism of late gadolinium enhancement in patients with acute myocardial infarction.
- Abstract:
- PURPOSE: To investigate the mechanism of late gadolinium enhancement in irreversibly damaged myocardium in patients with acute myocardial infarct by determining kinetics of Gd-DTPA over time. METHODS: Twenty-nine patients (24 men; 64 +/- 9 years) with acute myocardial infarction were imaged with functional and gadolinium enhanced cardiovascular magnetic resonance (CMR) 18 minutes post 0.2 mmol/kg Gd-DTPA. T1 of blood, remote and enhanced myocardium, as well as microvascular obstruction (MVO) was determined before and 5-40 minutes post contrast injection (Look-Locker), and the partition coefficient (lambda) was calculated. RESULTS: T1 and lambda were significantly different from 5-40 minutes post contrast in enhanced (lambda = 0.90 +/- 0.09, p < 0.001) compared to remote myocardium (lambda = 0.40 +/- 0.07). lambda achieved a steady state in remote but increased continuously in infarcted myocardium and to an even greater extent in MVO. T1 of enhanced myocardium was higher from 5-15 minutes, equal at 20 minutes and lower 25-40 minutes post contrast compared to blood, indicating a changing contrast between blood and late gadolinium enhancement over time. CONCLUSION: Enhancement in patients with acute infarction is mainly due to an increased lambda, although reduced wash-in-wash-out adds to the effect. Differentiation between blood and enhanced myocardium may be difficult to achieve, if only little differences of T1 are available. Imaging at a later point will restore the contrast.
- Journal title abbreviation:
- J Cardiovasc Magn Reson
- Year:
- 2007
- Journal volume:
- 9
- Journal issue:
- 4
- Pages contribution:
- 653-8
- Language:
- eng
- Fulltext / DOI:
- doi:10.1080/10976640601105614
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/17578720
- Print-ISSN:
- 1097-6647
- TUM Institution:
- Klinik und Poliklinik für Nuklearmedizin
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