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Effects of Time, Dose, and Inversion Time for Acute Myocardial Infarct Size Measurements Based on Magnetic Resonance Imaging-Delayed Contrast Enhancement

Anja Wagner, MD^_*, Heiko Mahrholdt, MD, Louise Thomson, MD^_*, Stefan Hager, MD, Gabriel Meinhardt, MD, Wolfgang Rehwald, PhD^_*, Michele Parker, MS, RN^_*, Dipan Shah, MD, Udo Sechtem, MD, Raymond J. Kim, MD^_* and Robert M. Judd, PhD^_*,_*

^_* Duke Cardiovascular MR Center, Durham, North Carolina
Robert Bosch Medical Center, Stuttgart, Germany
Nashville Cardiovascular MRI Institute, Nashville, Tennessee

View larger version (52K): [in a new window]   Figure 1 Identical short-axis slices from one animal scanned at serial time points using the delayed-enhancement technique with an adjusted inversion time (TI) (upper row) and a fixed TI (lower row). Using an adjusted TI (upper row), both the appearance of the images and the spatial extent of enhancement did not change up to 40 min after injection of contrast agent. However, using a fixed TI (lower row), both the general appearance of the images and the spatial extent of enhancement changed over time.

View larger version (42K): [in a new window]   Figure 2 Direct comparison of the delayed-enhancement magnetic resonance images (MRI) acquired 40 min after administration of contrast agent using an adjusted inversion time (TI) (middle) and fixed TI (right) to the gold-standard histology (TTC) in one animal. Gd-DPTA = gadolinium diethylenetriamine-pentaacetate; MR = magnetic resonance; TI = inversion time; TTC = triphenyltetrazolium chloride.

View larger version (11K): [in a new window]   Figure 3 Effects of time (5 to 40 min), dose (0.1 mmol/kg vs. 0.2 mmol/kg), and inversion time (TI) (adjusted vs. fixed) on infarct size measurements (magnetic resonance imaging [MRI]/ triphenyltetrazolium chloride [TTC] ratio). Using an adjusted TI, infarct size is independent of dose and time within the tested limits. Using a fixed TI, however, infarct size becomes a function of dose and time.

View larger version (122K): [in a new window]   Figure 4 Full set of short-axis views of the two magnetic resonance imaging (MRI) scans (5 and 30 min after injection of 0.15 mmol/kg gadolinium diethylenetriamine-pentaacetate) in three different patients. The presence, location, and size of the enhanced regions are similar in both MRI scans.

View larger version (8K): [in a new window]   Figure 5 Results of Bland-Altman repeatability analyses of the magnetic resonance imaging (MRI) data of all 48 patients expressed in percent left ventricular (LV) mass (A) and mass in grams (B). See text for details.