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Late gadolinium-enhanced magnetic resonance imaging in acute and chronic myocardial infarction

Improved prediction of regional myocardial contraction in the chronic state by measuring thickness of nonenhanced myocardium

Yasutaka Ichikawa, MD^*, Hajime Sakuma, MD^,*, Naohisa Suzawa, MD^*, Kakuya Kitagawa, MD, Katsutoshi Makino, MD, Tadanori Hirano, MD^* and Kan Takeda, MD

^* Department of Radiology, Matsusaka Central Hospital, Mie, Japan
Department of Radiology, Mie University Hospital, Mie, Japan
Department of Internal Medicine, Matsusaka Central Hospital, Mie, Japan

View larger version (132K): [in a new window]   Figure 1 Contrast-enhanced magnetic resonance images in the acute state (A) and chronic state (B), and cine images in the chronic state (C, diastole; D, systole) in Patient #11 after an inferior myocardial infarction. The inferior wall demonstrated normal wall thickening on the cine images acquired in the chronic state.

View larger version (145K): [in a new window]   Figure 2 Contrast-enhanced magnetic resonance images in the acute state (A) and chronic state (B), and cine images in the chronic state (C, diastole; D, systole) in Patient #12 after an anteroseptal myocardial infarction. The contractility of the anteroseptal wall was not improved in the chronic state in this patient.

View larger version (51K): [in a new window]   Figure 3 The relationship between the thickness of nonenhanced myocardium on scan 1 (A) and scan 2 (B) and systolic wall thickening in the chronic state, as well as the relationship between the percent transmural enhancement on scan 1 (C) and scan 2 (D) and systolic wall thickening in the chronic state in the 216 segments showing late enhancement.

View larger version (20K): [in a new window]   Figure 4 The receiver operating characteristic curves of contrast-enhanced cardiac magnetic resonance imaging with the measurements of percent transmural enhancement (dotted line) and with measurements of thickness of nonenhanced myocardium (solid line) for detecting preserved contractile function in the chronic state. The area under the receiver operating characteristic curve with the measurements of thickness of nonenhanced myocardium was significantly higher than that with the measurements of percent transmural enhancement for both scans 1 and 2.

View larger version (22K): [in a new window]   Figure 5 The receiver operating characteristic curves of late gadolinium-enhanced cardiac magnetic resonance imaging with the measurements of percent transmural enhancement (dotted line) and with measurements of thickness of nonenhanced myocardium (solid line) for detecting improved contractile function from scan 1 to 2 in the 110 segments showing impaired contractile function on scan 1 (<22% systolic wall thickening). The area under the receiver operating characteristic curve with the measurements of thickness of nonenhanced myocardium was significantly higher than that with measurements of percent transmural enhancement.