TY - JOUR
T1 - MR imaging of myocardial perfusion and viability
AU - Wagner, Anja
AU - Mahrholdt, Heiko
AU - Sechtem, Udo
AU - Kim, Raymond J.
AU - Judd, Robert M.
N1 - Funding Information:
This work was supported by a grant from the Deutsche Forschungsgemeinschaft (AW), the Robert Bosch Foundation (HM), the NIH R01-HL64726 (RJK), and the NIH R01-HL63268 (RMJ).
PY - 2003/2
Y1 - 2003/2
N2 - CMR is a rapidly developing new modality with applications in clinical cardiology for detection and assessment of myocardial ischemia and viability. CMR perfusion results for the detection of ischemia in comparison with stress echocardiography and scintigraphic techniques are reasonable, but all the studies reported to date have been conduced in selected patients. Larger studies in patient populations reflecting a broader spectrum of disease are necessary before perfusion CMR can be envisaged as a clinically reliable and robust diagnostic tool. Other CMR techniques provide a variety of novel methods of obtaining information on postischemic viability. Signs of viability that can be observed by CMR are the absence of late gadolinium-based contrast enhancement in a myocardial region involved in a recent infarct, any sign of wall thickening at rest (which is detectable with high accuracy by CMR), wall thickening after stimulation by low-dose dobutamine, and preserved wall thickness. Conversely, myocardial necrosis is characterized by signal enhancement of the infarct area after injection of Gd-DTPA, reduced wall thickness in chronic infarcts, and absence of a contractile reserve during dobutamine stimulation. Dobutamine CMR and late enhancement contrast-enhanced CMR predict contractile improvement after revascularization.
AB - CMR is a rapidly developing new modality with applications in clinical cardiology for detection and assessment of myocardial ischemia and viability. CMR perfusion results for the detection of ischemia in comparison with stress echocardiography and scintigraphic techniques are reasonable, but all the studies reported to date have been conduced in selected patients. Larger studies in patient populations reflecting a broader spectrum of disease are necessary before perfusion CMR can be envisaged as a clinically reliable and robust diagnostic tool. Other CMR techniques provide a variety of novel methods of obtaining information on postischemic viability. Signs of viability that can be observed by CMR are the absence of late gadolinium-based contrast enhancement in a myocardial region involved in a recent infarct, any sign of wall thickening at rest (which is detectable with high accuracy by CMR), wall thickening after stimulation by low-dose dobutamine, and preserved wall thickness. Conversely, myocardial necrosis is characterized by signal enhancement of the infarct area after injection of Gd-DTPA, reduced wall thickness in chronic infarcts, and absence of a contractile reserve during dobutamine stimulation. Dobutamine CMR and late enhancement contrast-enhanced CMR predict contractile improvement after revascularization.
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U2 - 10.1016/S1064-9689(02)00048-X
DO - 10.1016/S1064-9689(02)00048-X
M3 - Review article
C2 - 12797510
AN - SCOPUS:0037301847
SN - 1064-9689
VL - 11
SP - 49
EP - 66
JO - Magnetic Resonance Imaging Clinics of North America
JF - Magnetic Resonance Imaging Clinics of North America
IS - 1
ER -