Basic and clinical research of Gd-DTPA enhanced MR imaging and analysis of cardiac function in the patients with myocardial infarction

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PURPOSE : We assessed the effectiveness of gadopentetate dimeglumine injection in enhancing signal-intensity differences between normal and infarcted myocardium on ECG-gated spin-echo T1-weighted images. MATERIALS AND METHODS : The 84 MR examinations of 66 patients 14-350 days after acute myocardial infarction were obtained before and after administration of 0.1mmol/kg of Gd-DTPA (gadopentetate dimeglumine). Image acquisitions were repeated every 5 min with 3 minutes gap for up to 26 min in three sequential scans in 58 patients, and for up to 42 min in five sequential scans in ten patients. Time-dependent changes in signal intensity ratio between infarcted and normal myocardium (infarct/normal ratio) and serial changes of infarct/normal ratio in different stages were measured. RESULTS : Contrast enhancement of the infarcted myocardium was observed in 66 of 84 patients (78.6%). Infarct/normal ratio was increased at the initial acquisition during 5-10 minutes, reached the plateau at 13-18 minutes of acquisition, 21-26 minutes, and 29-34 minutes, and the augmented ratios gradually declined at 37-42 minutes. Contrast enhancement of the infarcted myocardium was observed in 9 of 10 (90.0%) imaged at 1-3 weeks after acute myocardial infarction, in 16 of 19 examinations (84.2%) at 4-6 weeks, in 24 of 29 (82.8%) at 7-9 weeks, in 16 of 21 (76.2%) at 10-32 weeks, and in none of 5 (0%) at 33-50 weeks. CONCLUSION : These results suggest that Gd-DTPA can improve MR visualization and detection of myocardial infarction, and facilitates the process of the repair of the myocardial infarction.