Determination of location, size, and transmurality of chronic myocardial infarction without exogenous contrast media by using cardiac magnetic resonance imaging at 3 T

Avinash Kali, Ivan Cokic, Richard L Q Tang, Hsin Jung Yang, Behzad Sharif, Eduardo Marbán, Debiao Li, Daniel S. Berman, Rohan Dharmakumar

Research output: Contribution to journalArticle

Abstract

Background-Late-gadolinium-enhanced (LGE) cardiac MRI (CMR) is a powerful method for characterizing myocardial infarction (MI), but the requisite gadolinium infusion is estimated to be contraindicated in ≈20% of patients with MI because of end-stage chronic kidney disease. The purpose of this study is to investigate whether T1 CMR obtained without contrast agents at 3 T could be an alternative to LGE CMR for characterizing chronic MIs using a canine model of MI. Methods and Results-Canines (n=29) underwent CMR at 7 days (acute MI [AMI]) and 4 months (chronic MI [CMI]) after MI. Infarct location, size, and transmurality measured by using native T1 maps and LGE images at 1.5 T and 3 T were compared. Resolution of edema between AMI and CMI was examined with T2 maps. T1 maps overestimated infarct size and transmurality relative to LGE images in AMI (P=0.016 and P=0.007, respectively), which was not observed in CMI (P=0.49 and P=0.81, respectively) at 3 T. T1 maps underestimated infarct size and transmurality relative to LGE images in AMI and CMI (P1 of the infarcted myocardium was increased in CMI and AMI (P2 of the infarcted myocardium was increased in AMI (P0.20) at both feld strengths. Histology showed extensive replacement fbrosis within the CMI territories. CMI detection sensitivity and specifcity of T1 CMR at 3 T were 95% and 97%, respectively. Conclusions-Native T1 maps at 3 T can determine the location, size, and transmurality of CMI with high diagnostic accuracy. Patient studies are necessary for clinical translation.

Original languageEnglish (US)
Pages (from-to)471-481
Number of pages11
JournalCirculation: Cardiovascular Imaging
Volume7
Issue number3
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Gadolinium
Contrast Media
Myocardial Infarction
Magnetic Resonance Imaging
Canidae
Myocardium
Chronic Renal Insufficiency
Chronic Kidney Failure
Edema
Histology

Keywords

  • Fbrosis
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Determination of location, size, and transmurality of chronic myocardial infarction without exogenous contrast media by using cardiac magnetic resonance imaging at 3 T. / Kali, Avinash; Cokic, Ivan; Tang, Richard L Q; Yang, Hsin Jung; Sharif, Behzad; Marbán, Eduardo; Li, Debiao; Berman, Daniel S.; Dharmakumar, Rohan.

In: Circulation: Cardiovascular Imaging, Vol. 7, No. 3, 2014, p. 471-481.

Research output: Contribution to journalArticle

Kali, Avinash ; Cokic, Ivan ; Tang, Richard L Q ; Yang, Hsin Jung ; Sharif, Behzad ; Marbán, Eduardo ; Li, Debiao ; Berman, Daniel S. ; Dharmakumar, Rohan. / Determination of location, size, and transmurality of chronic myocardial infarction without exogenous contrast media by using cardiac magnetic resonance imaging at 3 T. In: Circulation: Cardiovascular Imaging. 2014 ; Vol. 7, No. 3. pp. 471-481.
@article{2cf26092a74245e8ace5bbce6129cd0e,
title = "Determination of location, size, and transmurality of chronic myocardial infarction without exogenous contrast media by using cardiac magnetic resonance imaging at 3 T",
abstract = "Background-Late-gadolinium-enhanced (LGE) cardiac MRI (CMR) is a powerful method for characterizing myocardial infarction (MI), but the requisite gadolinium infusion is estimated to be contraindicated in ≈20{\%} of patients with MI because of end-stage chronic kidney disease. The purpose of this study is to investigate whether T1 CMR obtained without contrast agents at 3 T could be an alternative to LGE CMR for characterizing chronic MIs using a canine model of MI. Methods and Results-Canines (n=29) underwent CMR at 7 days (acute MI [AMI]) and 4 months (chronic MI [CMI]) after MI. Infarct location, size, and transmurality measured by using native T1 maps and LGE images at 1.5 T and 3 T were compared. Resolution of edema between AMI and CMI was examined with T2 maps. T1 maps overestimated infarct size and transmurality relative to LGE images in AMI (P=0.016 and P=0.007, respectively), which was not observed in CMI (P=0.49 and P=0.81, respectively) at 3 T. T1 maps underestimated infarct size and transmurality relative to LGE images in AMI and CMI (P1 of the infarcted myocardium was increased in CMI and AMI (P2 of the infarcted myocardium was increased in AMI (P0.20) at both feld strengths. Histology showed extensive replacement fbrosis within the CMI territories. CMI detection sensitivity and specifcity of T1 CMR at 3 T were 95{\%} and 97{\%}, respectively. Conclusions-Native T1 maps at 3 T can determine the location, size, and transmurality of CMI with high diagnostic accuracy. Patient studies are necessary for clinical translation.",
keywords = "Fbrosis, Myocardial infarction",
author = "Avinash Kali and Ivan Cokic and Tang, {Richard L Q} and Yang, {Hsin Jung} and Behzad Sharif and Eduardo Marb{\'a}n and Debiao Li and Berman, {Daniel S.} and Rohan Dharmakumar",
year = "2014",
doi = "10.1161/CIRCIMAGING.113.001541",
language = "English (US)",
volume = "7",
pages = "471--481",
journal = "Circulation: Cardiovascular Imaging",
issn = "1941-9651",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Determination of location, size, and transmurality of chronic myocardial infarction without exogenous contrast media by using cardiac magnetic resonance imaging at 3 T

AU - Kali, Avinash

AU - Cokic, Ivan

AU - Tang, Richard L Q

AU - Yang, Hsin Jung

AU - Sharif, Behzad

AU - Marbán, Eduardo

AU - Li, Debiao

AU - Berman, Daniel S.

AU - Dharmakumar, Rohan

PY - 2014

Y1 - 2014

N2 - Background-Late-gadolinium-enhanced (LGE) cardiac MRI (CMR) is a powerful method for characterizing myocardial infarction (MI), but the requisite gadolinium infusion is estimated to be contraindicated in ≈20% of patients with MI because of end-stage chronic kidney disease. The purpose of this study is to investigate whether T1 CMR obtained without contrast agents at 3 T could be an alternative to LGE CMR for characterizing chronic MIs using a canine model of MI. Methods and Results-Canines (n=29) underwent CMR at 7 days (acute MI [AMI]) and 4 months (chronic MI [CMI]) after MI. Infarct location, size, and transmurality measured by using native T1 maps and LGE images at 1.5 T and 3 T were compared. Resolution of edema between AMI and CMI was examined with T2 maps. T1 maps overestimated infarct size and transmurality relative to LGE images in AMI (P=0.016 and P=0.007, respectively), which was not observed in CMI (P=0.49 and P=0.81, respectively) at 3 T. T1 maps underestimated infarct size and transmurality relative to LGE images in AMI and CMI (P1 of the infarcted myocardium was increased in CMI and AMI (P2 of the infarcted myocardium was increased in AMI (P0.20) at both feld strengths. Histology showed extensive replacement fbrosis within the CMI territories. CMI detection sensitivity and specifcity of T1 CMR at 3 T were 95% and 97%, respectively. Conclusions-Native T1 maps at 3 T can determine the location, size, and transmurality of CMI with high diagnostic accuracy. Patient studies are necessary for clinical translation.

AB - Background-Late-gadolinium-enhanced (LGE) cardiac MRI (CMR) is a powerful method for characterizing myocardial infarction (MI), but the requisite gadolinium infusion is estimated to be contraindicated in ≈20% of patients with MI because of end-stage chronic kidney disease. The purpose of this study is to investigate whether T1 CMR obtained without contrast agents at 3 T could be an alternative to LGE CMR for characterizing chronic MIs using a canine model of MI. Methods and Results-Canines (n=29) underwent CMR at 7 days (acute MI [AMI]) and 4 months (chronic MI [CMI]) after MI. Infarct location, size, and transmurality measured by using native T1 maps and LGE images at 1.5 T and 3 T were compared. Resolution of edema between AMI and CMI was examined with T2 maps. T1 maps overestimated infarct size and transmurality relative to LGE images in AMI (P=0.016 and P=0.007, respectively), which was not observed in CMI (P=0.49 and P=0.81, respectively) at 3 T. T1 maps underestimated infarct size and transmurality relative to LGE images in AMI and CMI (P1 of the infarcted myocardium was increased in CMI and AMI (P2 of the infarcted myocardium was increased in AMI (P0.20) at both feld strengths. Histology showed extensive replacement fbrosis within the CMI territories. CMI detection sensitivity and specifcity of T1 CMR at 3 T were 95% and 97%, respectively. Conclusions-Native T1 maps at 3 T can determine the location, size, and transmurality of CMI with high diagnostic accuracy. Patient studies are necessary for clinical translation.

KW - Fbrosis

KW - Myocardial infarction

UR - http://www.scopus.com/inward/record.url?scp=84904088159&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84904088159&partnerID=8YFLogxK

U2 - 10.1161/CIRCIMAGING.113.001541

DO - 10.1161/CIRCIMAGING.113.001541

M3 - Article

C2 - 24682268

AN - SCOPUS:84904088159

VL - 7

SP - 471

EP - 481

JO - Circulation: Cardiovascular Imaging

JF - Circulation: Cardiovascular Imaging

SN - 1941-9651

IS - 3

ER -