Measurement of the Gadopentetate Dimeglumine Partition Coefficient in Human Myocardium in Vivo: Normal Distribution and Elevation in Acute and Chronic Infarction

Flacke, Sebastian; Fischer, Stefan; Lorenz, Christine H.

doi:10.1148/radiology.218.3.r01fe18703

Cited by 188 publications

(153 citation statements)

References 33 publications

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“…The DTPA is partitioned into the extracellular space, carrying the gadolinium as the contrast agent. In myocardium affected by increased extracellular space, gadolinium has a higher partition coefficient, 22 leading to significant signal enhancement, particularly if normal myocardium is nulled. 23 Late gadolinium enhancement CMR in the first 7 amyloid patients showed the unusual appearance of a dark blood pool and diminishing subendocardial enhancement over time, which suggested abnormal gadolinium-DTPA kinetics.…”

Section: Cardiovascular Magnetic Resonancementioning

confidence: 99%

Cardiovascular Magnetic Resonance in Cardiac Amyloidosis

Maceira

Joshi²,

Prasad³

et al. 2005

Circulation

867

446

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Section: Cardiovascular Magnetic Resonancementioning

confidence: 99%

Cardiovascular Magnetic Resonance in Cardiac Amyloidosis

Maceira

Joshi²,

Prasad³

et al. 2005

Circulation

867

446

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“…A commercially available extracellular gadolinium-based contrast agent (gadoteric acid, Gd-DOTA, Guerbet, Gothia Medical AB, Billdal, Sweden) was administered intravenously (0.2 mmol/kg) 30 ± 9 (SD) minutes before image acquisition. DE-MRI using the IR-GRE sequence utilizes an increase in regional fractional distribution of extracellular MRI contrast media within the injured area to achieve contrast between infarcted and non-infarcted myocardium (17)(18)(19)(20). The inversion time (TI) was adjusted to null the signal from the non-infarcted myocardium.…”

Section: Study Protocolmentioning

confidence: 99%

Size and transmural extent of first-time reperfused myocardial infarction assessed by cardiac magnetic resonance can be estimated by 12-lead electrocardiogram

Engblom

Hedström

Heiberg

et al. 2005

American Heart Journal

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“…To estimate v e using this method, a slow infusion or a bolus injection (7-10) of contrast agent is given and allowed to reach a near-equilibrium state of contrast agent transfer into and out of the tissue. At equilibrium, the ratio of the concentration of contrast agent in the vasculature to the concentration of contrast agent in the extra-cellular extravascular space constitutes the partition coefficient (11). When the partition coefficient is scaled to account for the blood hematocrit, then the steady-state ratio of contrast agent in the tissue and blood, Ct/Cb, directly reflects the myocardial distribution volume, v e (10,12,13).…”

Section: Introductionmentioning

confidence: 99%

Quantitative myocardial distribution volume from dynamic contrast-enhanced MRI

Pack

DiBella

Wilson

et al. 2008

Magnetic Resonance Imaging

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The objective of this study was to investigate if dynamic contrast-enhanced magnetic resonance imaging (MRI) can be used to quantitate the distribution volume (v e ) in regions of normal and infarcted myocardium. v e reflects the volume of the extra-cellular, extra-vascular space within the myocardial tissue. In regions of the heart where an infarct has occurred, the loss of viable cardiac cells results in an elevated v e compared to normal regions. A quantitative estimate of the magnitude and spatial distribution of v e is significant because it may provide information complementary to delayed enhancement MRI alone.Using a hybrid gradient echo-echo planar imaging (GRE-EPI) pulse sequence on a 1.5T MRI scanner, 12 normal subjects and four infarct patients were imaged dynamically, during the injection of a contrast agent, to measure the regional blood and tissue enhancement in the left ventricular (LV) myocardium. Seven of the normal subjects and all of the infarct patients were also imaged at steadystate contrast enhancement to estimate the steady-state ratio of contrast agent in the tissue and blood (Ct/Cb)-a validated measure of v e . Normal and infarct regions of the LV were manually selected and the blood and tissue enhancement curves were fit to a compartment model to estimate v e . Also, the effect of the vascular blood signal on estimates of v e was evaluated using simulations and in the dynamic and steady-state studies.Aggregate estimates of v e were 23.6% ± 6.3% in normal myocardium and 45.7% ± 3.4% in regions of infarct. These results were not significantly different from the reference standards of Ct/Cb (22.9% ± 6.8% and 42.6% ± 6.3%, p=0.073). From the dynamic contrast-enhanced studies, approximately one minute of scan time was necessary to estimate v e in the normal myocardium to within 10% of the steady-state estimate. In regions of infarct, up to three minutes of dynamic data was required to estimate v e to within 10% of the steady-state v e value.By measuring the kinetics of blood and tissue enhancement in the myocardium during an extended dynamic contrast enhanced MRI study, v e may be estimated using compartment modeling.

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Measurement of the Gadopentetate Dimeglumine Partition Coefficient in Human Myocardium in Vivo: Normal Distribution and Elevation in Acute and Chronic Infarction

Abstract: Quantification of the lambda in vivo allows differentiation between normal and acutely or chronically infarcted myocardium, with high sensitivity and specificity.

Cited by 188 publications

References 33 publications

Cardiovascular Magnetic Resonance in Cardiac Amyloidosis

Cardiovascular Magnetic Resonance in Cardiac Amyloidosis

Size and transmural extent of first-time reperfused myocardial infarction assessed by cardiac magnetic resonance can be estimated by 12-lead electrocardiogram

Quantitative myocardial distribution volume from dynamic contrast-enhanced MRI

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