Magnetic Resonance Imaging

نویسندگان

  • Maurits A. Jansen
  • Jan G. Van Emous
چکیده

Background—Because of rapid changes in myocardial intracellular Na (Na i) during ischemia and reperfusion (R), Na magnetic resonance imaging (MRI) appears to be an ideal diagnostic modality for early detection of myocardial ischemia and viability. So far, cardiac Na MRI data are limited and mostly concerned with imaging of total Na . For proper interpretation, imaging of both Na i and extracellular Na is essential. In this study, we tested whether Na i imaging can be used to assess viability after low-flow (LF) ischemia. Methods and Results—Isolated rat hearts were subjected to LF (1%, 2%, or 3% of control coronary flow) and R. A shift reagent was used to separate Na i and extracellular Na resonances. Acquisition-weighted Na chemical shift imaging (CSI) was alternated with Na MR spectroscopy. Already during control perfusion, Na i could be clearly seen on the images. Na i image intensity increased with increasing severity of ischemia. During R, Na i image intensity remained highest in 1% LF hearts. Not only did we find very good correlations between Na i image intensity at end-R and end-diastolic pressure (R 0.85, P 0.001) and recovery of the rate-pressure product (R 0.88, P 0.001) at end-R, but most interestingly, also Na i image intensity at end-LF was well correlated with end-diastolic pressure (R 0.78, P 0.01) and with recovery of the rate-pressure product (R 0.81, P 0.01) at end-R. Furthermore, Na i image intensity at end-LF was well correlated with creatine kinase release during R (R 0.79, P 0.05) as well as with infarct size (R 0.77, P 0.05). Conclusions—These data indicate that Na CSI is a promising tool for the assessment of myocardial viability. (Circulation. 2004;110:3457-3464.)

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تاریخ انتشار 2004