PMID- 21182141
OWN - NLM
STAT- MEDLINE
DCOM- 20110415
LR  - 20191210
IS  - 1522-2586 (Electronic)
IS  - 1053-1807 (Linking)
VI  - 33
IP  - 1
DP  - 2011 Jan
TI  - Papillary muscle involvement in myocardial infarction: initial results using 
      multicontrast late-enhancement MRI.
PG  - 211-6
LID - 10.1002/jmri.22394 [doi]
AB  - We hypothesized that multicontrast late-enhancement (MCLE) MRI would improve the 
      identification of papillary muscle involvement (PM-MI) in patients with 
      myocardial infarction (MI), compared with conventional late gadolinium 
      enhancement (LGE) MRI using the inversion recovery fast gradient echo (IR-FGRE) 
      technique. Cardiac LGE-MRI studies using both MCLE and IR-FGRE pulse sequences 
      were performed on a 1.5 Tesla (T) MRI system in 23 patients following MI. In all 
      patients, PM-MI was confirmed by the diagnostic criteria as outlined below: (a) 
      the increased signal intensity of PM was the same or similar to that of adjacent 
      hyper-enhanced left ventricular (LV) infarct segments; and (b) the hyper-enhanced 
      PM region was limited to the PM area defined by precontrast cine images of 
      steady-state free precession (SSFP). Visual contrast score was rated according to 
      the differentiation between LV blood pool and hyper-enhanced infarct myocardium. 
      Quantitative contrast-noise ratios (CNR) of infarct relative to blood pool and 
      viable myocardium were also measured on MCLE and IR-FGRE images. Of these 23 
      patients, 13 studies demonstrated primarily involvement of the territories of the 
      right coronary (RCA, 8 patients) and/or left circumflex (LCX, 5 patients) 
      arteries and 10 involved the territories of left anterior descending artery (LAD) 
      with some LCX involvement. Although both IR-FGRE and MCLE determined the presence 
      and extent of LV MI, better visual contrast scores were achieved in MCLE (2.9 +/- 
      0.3) compared with IR-FGRE (1.6 +/- 0.8, P < 0.001). The CNRs of infarct relative 
      to LV blood pool showed a significant statistical difference (n = 23, P < 
      0.00001) between MCLE (16.2 +/- 7.2) and IR-FGRE images (4.8 +/- 4.1), which is 
      consistent with the result of visual contrast scores between infarct and LV blood 
      pool. The CNRs of infarct versus viable myocardium did not demonstrate a 
      significant statistical difference (n = 23, P = 0.61) between MCLE (14.4 +/- 7.0) 
      and IR-FGRE images (13.6 +/- 6.1). MCLE clearly demonstrated PM-MI in all cases 
      (100%, 23/23) while only 39% (9/23) could be visualized on the corresponding 
      IR-FGRE images. In conclusion, MCLE imaging provides better contrast between 
      blood pool and infarct myocardium, thus improving the determination of PM-MI.
CI  - Copyright (c) 2010 Wiley-Liss, Inc.
FAU - Yang, Yuesong
AU  - Yang Y
AD  - Imaging Research and Cardiology, Sunnybrook Health Sciences Centre, University of 
      Toronto, Toronto, Ontario, Canada. ysyang@sri.utoronto.ca
FAU - Connelly, Kim
AU  - Connelly K
FAU - Graham, John J
AU  - Graham JJ
FAU - Detsky, Jay
AU  - Detsky J
FAU - Lee, Tony
AU  - Lee T
FAU - Walcarius, Rhonda
AU  - Walcarius R
FAU - Paul, Gideon
AU  - Paul G
FAU - Wright, Graham A
AU  - Wright GA
FAU - Dick, Alexander J
AU  - Dick AJ
LA  - eng
GR  - Canadian Institutes of Health Research/Canada
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Magn Reson Imaging
JT  - Journal of magnetic resonance imaging : JMRI
JID - 9105850
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Contrast Media/administration & dosage
MH  - Female
MH  - Gadolinium DTPA/*administration & dosage
MH  - Humans
MH  - Image Enhancement/*methods
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*pathology
MH  - Papillary Muscles/*pathology
MH  - Pilot Projects
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
EDAT- 2010/12/25 06:00
MHDA- 2011/04/19 06:00
CRDT- 2010/12/25 06:00
PHST- 2010/12/25 06:00 [entrez]
PHST- 2010/12/25 06:00 [pubmed]
PHST- 2011/04/19 06:00 [medline]
AID - 10.1002/jmri.22394 [doi]
PST - ppublish
SO  - J Magn Reson Imaging. 2011 Jan;33(1):211-6. doi: 10.1002/jmri.22394.