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EXPERIMENTAL STUDY

Imaging of myocardial infarction: comparison of magnevist and gadophrin-3 in rabbits

J.örg Barkhausen, MD^*,*, Wolfgang Ebert, PhD, J.örg F. Debatin, MD^* and Hanns-Joachim Weinmann, PhD

^* Department of Diagnostic Radiology, University Hospital Essen, Germany
Research Laboratories of Schering AG, Berlin, Germany

Manuscript received September 25, 2001; revised manuscript received January 9, 2002, accepted January 18, 2002.

^* Reprint requests and correspondence: Dr. Jörg Barkhausen, Department of Diagnostic Radiology, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany.
joerg.barkhausen{at}uni-essen.de

OBJECTIVES: This study was designed to determine the enhancement profile of a necrosis-specific contrast agent (gadophrin III) in comparison to a standard extracellular agent on T1-weighted magnetic resonance (MR) images in acute and chronic myocardial infarctions (MIs).

BACKGROUND: Contrast-enhanced MR imaging demonstrated the ability to accurately quantify infarct size; however, some controversies persist about which contrast medium is best suited.

METHODS: Fifteen rabbits underwent thoracotomy and permanent occlusion of a branch of the left coronary artery. Two animals died before imaging, eight were examined 48 h after occlusion and five animals were imaged six weeks following induction of infarction. All animals received 50 µmol/kg of gadophrin-3 24 h before the MR examination. Continuous short-axis views were collected using an inversion recovery turbo fast low angle shot sequence. Imaging was repeated 5 to 10 min following additional injection of 100 µmol/kg of Magnevist. The area of hyperenhancement demarcated following gadophrin-3 injection was compared with the region of hyperenhancement seen on gadophrin-3 plus Magnevist enhanced image using triphenyltetrazolium chloride (TTC) staining as the standard of reference.

RESULTS: In acute MI the mean difference in size of hyperenhancement seen on the two different in vivo MR scans was –1.8 ± 6.0 mm² (p > 0.05). Both measurements showed excellent agreement with TTC staining. Chronic MIs showed no enhancement with gadophrin-3, whereas application of Magnevist resulted in hyperenhancement.

CONCLUSIONS: Standard extracellular contrast agents do not overestimate the size of acute MI. The combination of gadophrin-3 and Magnevist can distinguish acute and chronic myocardial injury because chronic MIs do not enhance with gadophrin-3.

Abbreviations and Acronyms   AMI   acute myocardial infarction   CMI   chronic myocardial infarction   ECG   electrocardiogram   Gd-DTPA   gadolinium diethylene-triamino-penta-acetate   IRturboFLASH   inversion recovery turbo fast low angle shot   MI   myocardial infarction   MR   magnetic resonance   MRI   magnetic resonance imaging   T1   longitudinal relaxation time   T2   transversal relaxation time   TI   inversion time   TReff   effective repetition time   TRmin   minimum repetition time   TTC   triphenyltetrazolium chloride

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