Accurate and objective infarct sizing by contrast-enhanced magnetic resonance imaging in a canine myocardial infarction model
Luciano C. Amado, MD*,
Bernhard L. Gerber, MD*,
Sandeep N. Gupta, PhD ,
Dan W. Rettmann, BS,
Gilberto Szarf, MD ,
Robert Schock, PhD ,
Khurram Nasir, MD, MPH*,
Dara L. Kraitchman, VMD, PhD and
João A.C. Lima, MD*,*
* Cardiology
Radiology, Johns Hopkins University, School of Medicine, Baltimore, Maryland
GE Medical Systems, Waukesha, Wisconsin
Datascope Corporation, Mahwah, New Jersey
Manuscript received February 16, 2004;
accepted September 3, 2004.
* Reprint requests and correspondence: Dr. João A. C. Lima, Associate Professor of Medicine, Cardiology Division (Blalock 569), Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, Maryland 2187-6568 (Email: jlima{at}jhmi.edu).
OBJECTIVES: To identify an accurate and reproducible method to define myocardial infarct (MI) size, we conducted a study in a closed-chest canine model of acute myocardial infarction, in which MI size was measured using different thresholding techniques and by imaging at different delay times after contrast administration.
BACKGROUND: The MI size by contrast-enhanced magnetic resonance imaging (CE-MRI) is directly related to long-term prognosis. However, previous measurements were done using nonuniform methods and tended to overestimate nonviable areas.
METHODS: Thirteen animals underwent 90 min of coronary artery occlusion, followed by reperfusion. The CE-MRI data were acquired within 24 h after reperfusion and compared with triphenyltetrazolium chloride pathology. In the first nine animals, images were obtained  15 min after gadolinium diethylene triamine penta-acetic acid (Gd-DTPA) using an inversion-recovery gradient-echo pulse sequence. To identify the most accurate method, MI size by CE-MRI was measured visually and by semi-automatic thresholding techniques, using different criteria. In four additional animals, images were acquired every 6 min until 30 min after Gd-DTPA.
RESULTS: Postmortem MI size was 13.5 ± 2.6% of left ventricular volume. Semi-automatic techniques, using full-width at half-maximum (FWHM) criterion, correlated best with postmortem data (r2 = 0.94, p < 0.001; results confirmed by Bland-Altman plots). Using FWHM, there was no difference in MI size between different delay times after contrast (15.2 ± 2.9% to 14.5 ± 4.2% at 6 and 30 min, respectively; p = NS).
CONCLUSIONS: When an objective technique is used to define MI size by CE-MRI, accurate infarct size measurements can be obtained from images obtained up to 30 min after contrast administration.
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Abbreviations and Acronyms
| | CE = contrast-enhanced/enhancement | | FWHM = full-width at half-maximum | | Gd-DTPA = gadolinium diethylene triamine penta-acetic acid | | LV = left ventricle/ventricular | | MI = myocardial infarct/infarction | | MRI = magnetic resonance imaging | | TI = inversion recovery time | | TTC = triphenyltetrazolium chloride |
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|
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|
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