Cardiac magnetic resonance imaging: long term reproducibility of the late enhancement signal in patients with chronic coronary artery disease

Abstract

Objective: To determine long term reproducibility of the late enhancement (LE) signal in contrast enhanced magnetic resonance imaging (MRI) and potential changes of the signal after revascularisation. Methods: 33 patients (29 men, mean (SD) 61 (11) years) with coronary artery disease (CAD) and left ventricular dysfunction (ejection fraction 30 (7)%) underwent two contrast enhanced MRI procedures within 9 (3) months. Fifteen patients (group A: 14 men, 59 (12) years) had no interventions between the two studies. Eighteen patients underwent revascularisation after MRI 1 (group B: 15 men, 62 (9) years). Changes in the LE signal between the first and second MRIs were investigated in both groups as well as intraobserver and interobserver variabilities for delineation of the signal. Results: The LE signal was highly reproducible in groups A and B for segmental analysis (concordance 86% v 82%, respectively; k = 0.70 v 0.67) and summed scores (group A: r = 0.97, p , 0.001; group B: r = 0.93, p , 0.001). The LE signal was quantified as 27 (27) , respectively, for the second MRI (both not significant). Moreover, low intraobserver and interobserver variabilities were observed in segmental analysis (k = 0.86 and 0.74, respectively, for group A, and k = 0.87 and 0.82, respectively, for group B). Conclusion: In patients with chronic CAD, the LE signal in contrast enhanced MRI is very stable over an extended time period. These results further characterise contrast enhanced MRI as a useful tool for myocardial viability assessment. Low intraobserver and interobserver variabilities promise robustness of the method for clinical application.

MR-based analysis of regional cardiac function in relation to cellular integrity in Fabry disease

“…The consecutive reduction of contractile units results in hypokinesia. Similar findings are documented for patients with arrhythmogenic right ventricular dysplasia (ARVD) [20] and with ischemic cardiomyopathy [21,22]. In our patient group, the correlation between elevated LV mass and the presence of wall motion abnormalities was highly significant.…”

Identification of chronic myocardial infarction with extracellular or intravascular contrast agents in magnetic resonance imaging

“…Scarred myocardium exhibited a hyperenhancement in extracellular agent-enhanced T 1 images. This was consistent with previous research which demonstrated that chronic myocardial infarction appeared to be hyperenhanced in conjunction with extracellular agents [24,25] . The increased T 1 signal intensity of scarred myocardium reflects an enlarged distribution volume of extracellular agents resulting from the accessibility of a relatively larger extracellular compartment.…”

Quantitative myocardial distribution volume from dynamic contrast-enhanced MRI

“…DE MRI has become the gold standard for noninvasively identifying the presence and extent of myocardial scarring (2)(3)(4). DE MRI can also discriminate small regions of sub-endocardial infarct from viable tissue and has shown promise for reproducible sizing of infarcts and viability assessment in serial studies (5,6).…”