Kardiale MRT zur Quantifizierung der mikrovaskulären Obstruktion beim akuten Myokardinfarkt
| Autor: | K. U. Waltering, M. Hollenhorst, Joerg Barkhausen, Oliver Bruder, K Naßenstein, Peter Hunold, Thomas Schlosser |
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| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Percutaneous business.industry medicine.medical_treatment Infarction Thrombolysis medicine.disease Body weight Coronary revascularization Surgery Entire left ventricle Internal medicine medicine Cardiology Image acquisition Radiology Nuclear Medicine and imaging Myocardial infarction business |
| Zdroj: | RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren. 181:669-674 |
| ISSN: | 1438-9010 1438-9029 |
| Popis: | PURPOSE Microvascular obstruction (MO) and the extent of infarction are important prognostic factors in acute myocardial infarction. Our study aimed to investigate the effect of the time interval between contrast administration and image acquisition on the quantification of microvascular obstruction and myocardial infarction. MATERIALS AND METHODS 50 consecutive patients with acute myocardial infarction (40 male, mean age 58.1 +/- 11.7 years) treated by percutaneous coronary revascularization resulting in a grade 3 flow according to the thrombolysis in myocardial infarction flow classification were examined on a 1.5 T MR scanner within the first 5 days after infarction. 2, 5, 10, and 20 minutes after I.V. administration of 0.2 mmol/kg per kg body weight of Gadodiamid (Omniscan), GE Healthcare Buchler, Germany), a single shot IR-SSFP sequence (TR 2.4 ms, TE 1.08 ms, TI 180 - 280 ms, FA 50 degrees) covering the entire left ventricle was acquired. Areas of MO and myocardial infarction were measured for all times after contrast injection (p. i.). RESULTS MO was detected in 32 of 50 patients two minutes p. i., while 23 patients showed evidence of MO (p = 0.002) 20 min. p. i. In all patients with MO, the extent of MO decreased over time (7.4 +/- 9.0 % of the LV myocardium 2 min. p. i. vs. 2.4 +/- 4.6 % 20 min. p. i. p < 0.0001). The area of myocardial infarction increased from 13.9 +/- 13.5 % 2 min. p. i. to 18.6 +/- 14.2 % 10 min. p. i. (p < 0.0001), and then remained unchanged (18.7 +/- 14.3 % at 20 min. p = 0.57). CONCLUSION Our study shows that the time delay between contrast media injection and image acquisition has a significant impact on the delimitable extent of MO and infarct size. |
| Databáze: | OpenAIRE |
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