Summary
Early thrombolytic therapy restores patency of thrombotic coronary artery occlusion in many patients. Intravenous streptokinase appears to be effective in achieving recanalization of the occluded infarct-related artery, thereby reducing myocardial infarct size. However, it may be difficult to assess non-invasively the relative value of different reperfusion therapies. MR imaging with or without the use of contrast agents may become a reliable non-invasive technique to assess infarct size after reperfusion therapy. There are indications that early MR imaging after administration of Gd-DTPA is able to differentiate reperfused from non-reperfused infarcts. Furthermore, MR infarct sizing using Gd-DTPA can demonstrate infarct size reduction in patients with successful reperfusion. The availability of ultrafast imaging methods and MR contrast agents may allow assessment of myocardial perfusion in the near future. This article reviews the current status of MR imaging for evaluating ischemic myocardial disease.
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References
Atkinson DJ, Burstein D, Edelman RR. First-pass cardiac perfusion: evaluation with ultrafast MR imaging. Radiology 1990; 174: 757–62.
Pettigrew RI. Four-dimensional cardiac MR imaging: diagnostic procedure of the future. Eugene P. Pendergrass new horizons lecture. Radiology 1989; 173: 50.
Been M, Smith MA, Ridgway JP, et al. Serial changes in the T1 magnetic relaxation parameter after myocardial infarction in man. Br Heart J 1988; 59: 1–8.
Wisenberg G, Finnie KJ, Jablonsky G, Kostuk WJ, Marshall T. Nuclear magnetic resonance and radionuclide angiopraphic assessment of acute myocardial infarction in a randomized trial of intravenous streptokinase. Am J Cardiol 1988; 62: 1011–6.
Johnston DL, Mulvagh SL, Cashion RW, O'Neill PG, Roberts R, Rokey R. Nuclear magnetic resonance imaging of acute myocardial infarction within 24 hours of chest pain onset. Am J Cardiol 1989; 64: 172–9.
Postema S, De Roos A, Doornbos J, Krauss XH, Blokland JAC. Acute myocardial infarction: detection and localization by magnetic resonance imaging and thalliumscintigraphy. J Med Im 1989; 3: 68–74.
Johns JA, Leavitt MB, Newell JB, et al. Quantitation of acute myocardial infarct size by nuclear magnetic resonance imaging. J Am Coll Cardiol 1990; 15: 143–9.
Higgins CB. Nuclear magnetic resonance (NMR) imaging in ischemic heart disease. J Am Coll Cardiol 1990; 15: 150–1.
De Roos A, Van Rossum AC, Van der Wall EE, Postema S, Doornbos J, Matheijssen NAA, Van Dijkman PRM, Visser FC, Van Voorthuisen AE. Reperfused and non-reperfused myocardial infarction: potential of Gadolinium-DTPA enhanced MR imaging. Radiology 1989; 172: 717–20.
Eichstaedt HW, Felix R, Dougherty FC, Langer M, Rutsch W, Schmutzler H. Magnetic resonance imaging in different stages of myocardial infarction using the contrast agent Gadolinium-DTPA. Clin Cardiol 1986; 9: 527–35.
De Roos A, Doornbos J, Van der Wall EE, Van Voorthuisen AE. MR imaging of acute myocardial infarction: value of Gd-DTPA. Year Book of Medicine. E. Braunwald (ed). Year Book Medical Publishers, Chicago, 1989; 323–5.
De Roos A, Doornbos J, Van der Wall EE, Van Voorthuisen AE. MR imaging of acute myocardial infarction: value of Gd-DTPA. AJR 1988; 150: 531–4.
Van Dijkman PRM, Doornbos J, De Roos A, Van der Laarse A, Postema S, Matheijssen NAA, Bruschke AVG, Van Voorthuisen AE, Manger Cats V, Van der Wall EE. Improved detection of acute myocardial infarction by magnetic resonance imaging using Gadolinium-DTPA. Int J Cardiac Imag 1989; 5: 1–8.
Nishimura T, Kobayashi H, Ohara Y, et al. Serial Assessment of myocardial infarction by using gated MR imaging and Gd-DTPA. AJR 1989; 153: 715–20.
Van der Wall EE, Van Dijkman PRM, De Roos A, Doornbos J, Van der Laarse A, Manger Cats V, Van Voorthuisen AE, Matheijsen NAA, Bruschke AVG. Diagnostic significance of Gadolinium-DTPA enhanced magnetic resonance imaging in thrombolytic treatment for acute myocardial infarction: its potential in assessing reperfusion. Br Heart J 1990; 63: 12–7.
Van Rossum AC, Visser FC, Van Eenige MJ, et al. Value of Gadolinium-diethylene-triamine-pentaacetic acid dynamics in magnetic resonance imaging of acute myocardial infarction with occluded and reperfused coronary arteries after thrombolysis. Am J Cardiol 1990; 65: 845–51.
De Roos A, Matheijssen NAA, Doornbos J, Van Dijkman P, Van Voorthuisen AE, Van der Wall EE. Myocardial infarct size after reperfusion therapy: assessment by Gadolinium-DTPA-enhanced MR imaging. Radiology 1990; 176: 517–21.
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de Roos, A., Matheijssen, N.A.A., Doornbos, J. et al. Myocardial infarct sizing and assessment of reperfusion by magnetic resonance imaging: a review. Int J Cardiac Imag 7, 133–138 (1991). https://doi.org/10.1007/BF01798054
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DOI: https://doi.org/10.1007/BF01798054