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Cardiovascular magnetic resonance ofacute myocardial infarction at a very early stage

^* Franz Volhard Clinic at the Max Delbrück Center, Helios-Klinikum, Berlin-Buch, Medical Faculty of the Charité, Department Cardiology, Humboldt University of Berlin, Berlin, Germany

View larger version (90K): [in a new window]   Figure 1 Signal changes in the septal myocardial infarction in a follow-up detected by magnetic resonance imaging. (a) T2-weighted spin-echo sequences visualizing the edema. Sixty minutes after acute occlusion of the septal artery, there was no signal increase in the myocardium; the streaky artifacts visible adjacent to the septum and in the inferior parts in both ventricles are most likely due to slow flowing blood. (b) T1-weighted spin-echo imaging after gadolinium. Enhancment was detectable within 60 min of infarction.

View larger version (27K): [in a new window]   Figure 2 Changes over time in the infarcted and edematous areas. The affected area (%) = (area with signal abnormality/area of whole myocardium within slice) x 100. *Significant difference from day 0 (1 h after intervention) and days 28, 90, and 180 (p < 0.05). #Significant difference from days 1, 3, 7, 14, and 28 (p < 0.05). ##Significant difference from days 3 and 7 (p < 0.05). STIR = short T1 inversion recovery.

View larger version (72K): [in a new window]   Figure 3 Contrast-enhanced CMR images. (a) First image = long-axis view after the first intervention; second image = long-axis view after the second intervention, with enlarged contrast accumulation; third image = long-axis view with planned short-axis orientation; fourth image = short-axis view showing a high signal intensity in the chronic infarction (arrowhead) and a lower, but still high, signal intensity in the acute infarction (arrow). (b) T2-weighted images: short-axis view after the first intervention (left) and short-axis view after the second intervention (right). In contrast to the chronic infarction (arrowhead), the acute infarction shows a very high signal (arrow).