Magnetic resonance imaging of myocardial infarct

Bernhard L. Gerber, Joao A.C. Lima, Jerome Garot, David A. Bluemke

Research output: Contribution to journalReview articlepeer-review

Abstract

Magnetic resonance imaging offers the unique opportunity to directly visualize the size and location of myocardial infarcts (MIs) with excellent spatial resolution. Because infarct size is the most important determinant of postinfarct outcome, precise determination of infarct size may be valuable to risk stratify patients after acute MI. In addition, infarct imaging may provide direct information on the amount of irreversibly injured myocardium and thus can be used to identify myocardial viability in dysfunctional regions. Acute infarcts can be recognized as hyperintense signal on T2-weighted spin-echo images. This technique, however, does not identify chronic infarcts and may overestimate infarct size by including area at risk. Also, T2-weighted images often have a low signal-to-noise ratio. Contrast-enhanced perfusion imaging provides better-quality images. Extravascular contrast agents such as (Gd-DTPA) gadolinium diethyletriamine-pentaacetic acid identify infarcts as hyperenhanced regions on images acquired late after contrast injection. In addition, these tracers can examine the integrity and permeability of infarct microvasculature on first-pass perfusion images. Necrosis avid tracers and 23Na imaging are other new exciting approaches to identify infarcted myocardium acutely after MI. These techniques, are still investigational, and their value for clinical imaging remains to be established.

Original languageEnglish (US)
Pages (from-to)372-382
Number of pages11
JournalTopics in Magnetic Resonance Imaging
Volume11
Issue number6
DOIs
StatePublished - Dec 1 2000

Keywords

  • Contrast agent
  • Gadolinium
  • Magnetic resonance imaging
  • Myocardial infarct
  • Sodium 23

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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