Retrospective determination of the area at risk for reperfused acute myocardial infarction with T2-weighted cardiac magnetic resonance imaging - Histopathological and displacement encoding with stimulated echoes (DENSE) functional validations
Retrospective determination of the area at risk for reperfused acute myocardial infarction with T2-weighted cardiac magnetic resonance imaging - Histopathological and displacement encoding with stimulated echoes (DENSE) functional validations
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DOI：
10.1161/circulationaha.105.576025
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发表时间：
2006-04-18
期刊：
影响因子：
37.8
通讯作者：
Arai, AE
中科院分区：
文献类型：
--
作者：
Aletras, AH;Tilak, GS;Arai, AE
背景-本研究的目的是确定T2加权心脏磁共振（CMR）成像的水肿成像是否可以回顾性地描绘再灌注心肌梗死的危险区域。我们假设，在一个短暂的闭塞的风险区域的大小将是类似的T2加权高信号区域观察2天后，T2加权高信号心肌将显示部分功能恢复后2个月，T2异常将解决超过2 months.Methods和Results -17只狗进行了90分钟的冠状动脉闭塞，然后再灌注。用微球（9只动物）测量的风险区域与2天后T2加权图像上的高信号区大小相当（左心室43.4 +/- 3.3% vs 43.0 +/- 3.4%; P = NS），并且2种测量值相关（R = 0.84）。梗死区明显较小（23.1 ± 3.7;均P < 0.001）。为了测试高信号心肌是否会随着时间的推移表现出部分功能恢复，在第2天和2个月后对8只动物进行成像。用刺激回波位移编码法绘制收缩压应变图。水肿（通过T2加权图像上的高信号区检测到）消退，局部桡动脉收缩应变从4.9 ± 0.7部分改善至13.1 ± 1.5（P = 0.001）超过2个月。结论-这些发现与T2异常描述风险区域的前提一致，与再灌注内膜下梗死相关的可逆性和不可逆性损伤心肌区。缺血后水肿的持续存在使得T2加权CMR能够描绘再灌注心肌梗死后2天的危险区域。
Background - The aim of this study was to determine whether edema imaging by T2-weighted cardiac magnetic resonance (CMR) imaging could retrospectively delineate the area at risk in reperfused myocardial infarction. We hypothesized that the size of the area at risk during a transient occlusion would be similar to the T2-weighted hyperintense region observed 2 days later, that the T2- weighted hyperintense myocardium would show partial functional recovery after 2 months, and that the T2 abnormality would resolve over 2 months.Methods and Results - Seventeen dogs underwent a 90-minute coronary artery occlusion, followed by reperfusion. The area at risk, as measured with microspheres ( 9 animals), was comparable to the size of the hyperintense zone on T2- weighted images 2 days later (43.4 +/- 3.3% versus 43.0 +/- 3.4% of the left ventricle; P = NS), and the 2 measures correlated ( R = 0.84). The infarcted zone was significantly smaller (23.1 +/- 3.7; both P < 0.001). To test whether the hyperintense myocardium would exhibit partial functional recovery over time, 8 animals were imaged on day 2 and 2 months later. Systolic strain was mapped with displacement encoding with stimulated echoes. Edema, as detected by a hyperintense zone on T2- weighted images, resolved, and regional radial systolic strain partially improved from 4.9 +/- 0.7 to 13.1 +/- 1.5 ( P = 0.001) over 2 months.Conclusions - These findings are consistent with the premise that the T2 abnormality depicts the area at risk, a zone of reversibly and irreversibly injured myocardium associated with reperfused subendocardial infarctions. The persistence of postischemic edema allows T2-weighted CMR to delineate the area at risk 2 days after reperfused myocardial infarction.