Appearance of microvascular obstruction on high resolution first-pass perfusion, early and late gadolinium enhancement C
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Appearance of microvascular obstruction on high resolution first-pass perfusion, early and late gadolinium enhancement CMR in patients with acute myocardial infarction Adam N Mather1, Timothy Lockie2,3, Eike Nagel3, Michael Marber2, Divaka Perera2, Simon Redwood2, Aleksandra Radjenovic4, Ansuman Saha1, John P Greenwood1 and Sven Plein*1,3 Address: 1Division of Cardiovascular and Neuronal Remodelling, University of Leeds, UK, 2Cardiovascular Division, The Rayne Institute, King's College London, St Thomas' Campus, London, UK, 3Division of Imaging Sciences, The Rayne Institute, King's College London, St Thomas' Campus, UK and 4Division of Medical Physics, University of Leeds, UK Email: Adam N Mather - [email protected]; Timothy Lockie - [email protected]; Eike Nagel - [email protected]; Michael Marber - [email protected]; Divaka Perera - [email protected]; Simon Redwood - [email protected]; Aleksandra Radjenovic - [email protected]; Ansuman Saha - [email protected]; John P Greenwood - [email protected]; Sven Plein* - [email protected] * Corresponding author
Published: 21 August 2009 Journal of Cardiovascular Magnetic Resonance 2009, 11:33
doi:10.1186/1532-429X-11-33
Received: 5 May 2009 Accepted: 21 August 2009
This article is available from: http://www.jcmr-online.com/content/11/1/33 © 2009 Mather et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: The presence and extent of microvascular obstruction (MO) after acute myocardial infarction can be measured by first-pass gadolinium-enhanced perfusion cardiovascular magnetic resonance (CMR) or after gadolinium injection with early or late enhancement (EGE/LGE) imaging. The volume of MO measured by these three methods may differ because contrast agent diffusion into the MO reduces its apparent extent over time. Theoretically, first-pass perfusion CMR should be the most accurate method to measure MO, but this technique has been limited by lower spatial resolution than EGE and LGE as well as incomplete cardiac coverage. These limitations of perfusion CMR can be overcome using spatio-temporal undersampling methods. The purpose of this study was to compare the extent of MO by high resolution first-pass k-t SENSE accelerated perfusion, EGE and LGE. Methods: 34 patients with acute ST elevation myocardial infarction, treated successfully with primary percutaneous coronary intervention (PPCI), underwent CMR within 72 hours of admission. k-t SENSE accelerated first-pass perfusion MR (7 fold acceleration, spatial resolution 1.5 mm × 1.5 mm × 10 mm, 8 slices acquired over 2 RR intervals, 0.1 mmol/kg Gd-DTPA), EGE (14 minutes after injection with a fixed TI of 440 ms) and LGE images (1012 minutes after inj
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