Quantification of the extent of area at risk with fast contrast-enhanced magnetic resonance imaging in experimental coronary artery stenosis

Maythem Saeed, Michael F. Wendland, Dieter Szolar, Hajime Sakuma, Jean Francois Geschwind, Sebastian Globits, Nikita Derugin, Charles B. Higgins

Research output: Contribution to journalArticle

Abstract

Fast magnetic resonance (MR) imaging techniques have the capability of demonstrating regions of ischemia caused by stenosis. The size of the potentially ischemic area determines the importance of the stenosis. The purpose of this study was to determine the relative values of relaxivity- enhancing and magnetic-susceptibility MR contrast media in detecting and sizing the area at risk in dogs. Eight dogs were subjected to critical left circumflex coronary artery (LCX) stenosis. Sixty sequential inversion- recovery- and driven-equilibrium-prepared fast gradient recalled echo images were acquired during bolus administration of 0.03 mmol/kg gadodiamide or 0.4 mmol/kg sprodiamide in basal and vasodilated (dipyridamole-stress) states. The size of the area at risk was measured and compared with that measured post mortem. In the basal state, gadodiamide and sprodiamide equivalently altered the signal intensities of nonischemic myocardium and the territory of stenosed coronary artery. Dipyridamole produced a significant increase in left anterior descending coronary artery flow with a decrease in LCX flow. The hypoperfused region was observed as a low- and high-signal intensity region after administration of gadodiamide and sprodiamide, respectively. The size of the hypoperfused region was slightly smaller with gadodiamide (37.4% ± 2.8%) and sprodiamide (34.0% ± 2.2%) than the true area at risk measured post mortem (41.8% ± 2.2%; p < 0.05). Dipyridamole perfusion MR imaging with relaxivity or susceptibility contrast media is a noninvasive method to identify and quantify the area at risk in the territory of a stenotic coronary artery. Changes in myocardial signal intensity on fast gradient recalled echo images reflect the augmentation of flow and volume induced with dipyridamole and are consistent with the 'steal phenomenon'.

Original languageEnglish (US)
Pages (from-to)921-932
Number of pages12
JournalAmerican heart journal
Volume132
Issue number5
DOIs
StatePublished - Jan 1 1996

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Saeed, M., Wendland, M. F., Szolar, D., Sakuma, H., Geschwind, J. F., Globits, S., Derugin, N., & Higgins, C. B. (1996). Quantification of the extent of area at risk with fast contrast-enhanced magnetic resonance imaging in experimental coronary artery stenosis. American heart journal, 132(5), 921-932. https://doi.org/10.1016/S0002-8703(96)90000-9