The 3D double-echo steady-state sequence optimized for cartilage imaging improves lesion conspicuity but does not improve diagnostic performance.

Background-Metabolic assessment of dysfunctional myocardium by PET allows prediction of functional recovery after revascularization. Contrast-enhanced MR (ce-MR) discriminates transmural distribution of viable and scar tissue with excellent spatial resolution. Both techniques were applied in ischemic chronic left ventricular dysfunction to relate metabolism and tissue composition to changes of contractile function after revascularization. Methods and Results-Nineteen patients with myocardial infarctions (Ͼ3 months) were studied by MR and PET, and 10 patients were followed by MR 11Ϯ2 months after revascularization. In 56 to 64 segments/heart, systolic wall thickening, viable mass, and thickness of viable rim tissue were determined by MR (inversion-recovery MR with 0.25 mmol/kg Gd-chelate).[ 18 F]Fluorodeoxyglucose (FDG) uptake and resting perfusion ( 13 N-ammonia) were determined by PET. Viable tissue per segment on ce-MR correlated with FDG uptake per segment (rϭ0.62 and 0.82 for segments with and without flow metabolism mismatch, PϽ0.0001). FDG uptake Ն50% (a predictor of functional recovery) corresponded to a viable rim thickness of 4.5 mm on ce-MR. Thick (Ͼ4.5 mm) and metabolically viable segments (Ն50% FDG uptake) showed functional recovery in 85%, whereas thin metabolically nonviable segments improved function in 13% (PϽ0.0005). Metabolically viable segments with a thin viable rim and thick segments with reduced FDG uptake improved function in only 36% and 23% of segments, respectively (NS versus thin metabolically nonviable). In these 2 classes of segments, scar per segment was higher than in thick viable segments (PϽ0.0001). Conclusions-Metabolism and tissue composition discriminate various classes of dysfunctional myocardium. Most metabolically viable segments with a thick viable rim on ce-MR recover function after revascularization, whereas all other classes showed low recovery rates of contractile function.

VCE can readily depict and characterize subtle mucosal lesions missed at MRE, whereas MRE yields additional mural, perienteric, and extraenteric information. Thus, VCE and MRE appear to be complementary methods which, when used in conjunction, may better characterize suspected small bowel disease.