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Biomedical subjects

M Saeed

Publications and source records attributed to M Saeed.

At least 37 records · Page 2Linked to original sources

Very fast cardiac imaging.

With very fast MR imaging techniques, myocardial perfusion can be assessed by monitoring the changes of myocardial signal intensity over time following bolus injection of a contrast medium. Very fast MR imaging techniques also allow for freezing of cardiac motion that is important for coronary MR angiography and their high temporal resolution allow for coronary flow reserve measurements. In the current overview, basic principles and strategies of very fast cardiac MR imaging are presented. In the second part, applications of these fast sequences in the fields of myocardial perfusion, coronary MR angiography, and low measurements are presented.

Animals

Multislice measurement of first-pass transit of gadobenate dimeglumine in normal and ischemic myocardium in dogs.

RATIONALE AND OBJECTIVES: We monitored the differences in the first passage of gadobenate dimeglumine through normal and ischemic myocardium with left anterior descending (LAD) coronary artery occlusion in dogs. METHODS: Dynamic multislice images of the heart were taken on a 1.5-T magnetic resonance (MR) imager. In six normal dogs, inversion recovery (IR)-prepared fast gradient-recalled echo (GRE) images were acquired at five doses of gadobenate dimeglumine (0.005-0.1 mmol/kg). First passage of the contrast medium through normal and acutely ischemic myocardium were monitored in seven dogs subjected to LAD coronary artery occlusion. RESULTS: IR-prepared GRE images showed a dose-dependent increase in the signal intensity (SI) of the myocardium. In dogs with LAD coronary artery occlusion, there was a significant increase in the SI of normal myocardium (p < .01) than in ischemic myocardium after injection of 0.025 mmol/kg gadobenate dimeglumine. CONCLUSION: The first-pass dynamics of gadobenate dimeglumine through normal and ischemic myocardium can be monitored with a multislice acquisition using a clinical MR imager and differentiated between normal and ischemic myocardium in dogs.

Animals

Effects of iopromide on vasoactive peptides and allergy-mediated substances in healthy volunteers.

RATIONALE AND OBJECTIVES: Little information is available about the direct action of angiographic contrast media on vasoactive peptides and allergy-mediated substances in humans. This study defined the acute effects of iopromide, a nonionic contrast medium (370 mg/mL iodine), on vasoactive peptides, allergy-mediated substances, and hemodynamic parameters in healthy volunteers. METHODS: Pulmonary digital subtraction angiography was performed in seven healthy volunteers with no cardiovascular or pulmonary disease. Iopromide was administered as a total volume of 100 mL through a 7-Fr catheter inserted in the right femoral vein. The injected volumes and duration of injection (15-20 mL/second) were kept constant. The following hemodynamic parameters were monitored continuously: results of electrocardiogram, heart rate, and phasic and mean pulmonary arterial and peripheral arterial pressures. Blood samples were obtained before and 3 to 5 minutes after injection of contrast media to determine the concentrations of the following vasoactive peptides: renin, angiotensin I-converting enzyme, angiotensin II, aldosterone, atrial natriuretic peptide, antidiuretic hormone, cyclic guanosine monophosphate, and myoglobin; and to allergy-mediated substances such as tryptase, eosinophil protein X, and eosinophil cationic protein, using radioimmunoassay techniques. RESULTS: Iopromide substantially increased atrial natriuretic peptide (48.8 +/- 8.9 to 85.8 +/- 13.0) and antidiuretic hormone (3.4 +/- 0.3 to 4.6 +/- 0.5) levels, whereas renin decreased (0.9 +/- 0.1 to 0.8 +/- 0.2) slightly but not significantly. Iopromide did not induce substantial changes in the other vasoactive peptides or in allergy-mediated substances after the contrast medium was injected. Similarly, cardiovascular parameters (heart rate, pulmonary and systemic blood pressures, and results of electrocardiogram) also remained unchanged after contrast injection. CONCLUSION: Iopromide caused no appreciable hemodynamic alterations associated with the changes in atrial natriuretic peptide and antidiuretic hormone and no evidence of allergy-mediated reactions in all volunteers.

Adult

Coronary artery stenosis: detection with contrast-enhanced MR imaging in dogs.

PURPOSE: To monitor with fast gradient-echo magnetic resonance (MR) imaging the dynamics of gadolinium benzyloxypropionictetraacetate (gadobenate) dimeglumine on myocardial signal intensity in dogs with critical left circumflex coronary artery stenosis. MATERIALS AND METHODS: Fast gradient-echo MR images were acquired in a short axis of the left ventricle. Two bolus injections of 0.05 mmol/kg gadobenate dimeglumine were administered in the basal state after stenosis and after infusion of 0.5 mg/kg dipyridamole. RESULTS: In the basal state, there was an equivalent increase in signal intensity of normal and hypoperfused myocardium during the first pass. Dipyridamole increased left anterior descending flow (287% +/- 36; P < .05) and decreased left circumflex flow (65% +/- 14; P < .05). The magnitude of signal intensity increase during the second bolus in the hypoperfused region was less than that of normal myocardium (P < .05). Contrast-enhanced images showed the hypoperfused region as smaller than the postmortem measurement (43.8% +/- 3.3; P < .05). CONCLUSION: Contrast-enhanced fast MR imaging in the vasodilated state allows detection of hypoperfused myocardium in the presence of critical coronary stenosis.

Animals

Rheumatoid arthritis of the craniocervical region by MR imaging: detection and characterization.

OBJECTIVE: The purpose of our study was to evaluate the potential of contrast-enhanced MR imaging to detect and to characterize craniocervical rheumatoid arthritis in a large population group, to compare MR imaging with clinical and conventional radiographic findings, and to examine the relationship between the histopathologic and MR imaging findings in seven patients. SUBJECTS AND METHODS: We performed contrast-enhanced MR imaging using T2-weighted gradient-echo sequences and T1-weighted spin-echo sequences in 136 patients with rheumatoid arthritis. Sequential T1-weighted images were obtained before, 3 min after, and 15 min after injection of contrast material. Plain films were acquired in all patients. Serologic status and neurologic status were determined in each patient within 2 days of MR imaging. Patients were categorized into one of four groups, depending upon whether they had joint effusion, hypervascular pannus, hypovascular pannus, or fibrous pannus according to signal patterns on contrast-enhanced MR images. Signal intensity was measured to assess the enhancement of synovial hypertrophy, joint capsule, joint effusion, and the various stages of pannus tissue. Histologic specimens were obtained from seven patients and were correlated with MR imaging findings. RESULTS: Acute and chronic synovitis were differentiated with contrast-enhanced MR imaging as follows: joint effusion (n = 29), hypervascular pannus (n = 54), hypovascular pannus tissue (n = 8), and fibrous pannus (n = 22). Signal intensity differed significantly among the four groups on contrast-enhanced T1-weighted images. In 59 patients with effusion or hypervascular pannus tissue, atlantoaxial subluxation was diagnosed with plain films. Patients with negative findings on radiographic studies (n = 20) had joint effusion, hypervascular pannus tissue, hypovascular pannus formation, or fibrous pannus tissue on MR imaging studies. Cord compression was found in 10% of all cases and isolated sac compression in 16%. Neurologic findings showed no correlation with MR imaging features. CONCLUSION: Contrast-enhanced T1-weighted spin-echo MR imaging can discriminate between joint effusion and various forms of pannus in patients with rheumatoid arthritis of the craniocervical region. MR imaging also can detect joint effusion and pannus tissue in patients with negative radiographic findings. No relationship between MR imaging findings and clinical symptoms were found. Tissue enhancement and histopathologic findings correlated in a limited number of autopsies.

Acute Disease

The developing role of magnetic resonance contrast media in the detection of ischemic heart disease.

Recent developments in magnetic resonance (MR) imaging have opened up new avenues in the investigation of cardiovascular physiology. Inherent signal intensity of any tissue on MR images depends largely on proton concentration as well as longitudinal (T1) and transverse (T2) relaxation times. Myocardial contrast can be manipulated by using specific MR pulse sequences which are selectively sensitive to differences in any one of these parameters. Paramagnetic metal complexes are used as contrast media in MR imaging to enhance the inherent contrast. Contrast media in MR imaging are not directly visible but change the magnetic properties of other nuclei in close proximity, such as those of the water hydrogen. The signal of water can be altered by the contrast medium in different ways, either by changing the relaxation times or through bulb susceptibility effects, or both. The role of MR contrast media for quantitative characterization of ischemic heart disease has advanced considerably in the past 10 years. Conventional MR imaging techniques following the administration of contrast media are useful for identifying and sizing myocardial infarctions and for distinguishing between occlusive and reperfused myocardial infarctions as well as reversible (stunned) and irreversible injuries. Recent results suggest that contrast-enhanced MR imaging can also be used to identify dead cells in reperfused ischemically injured myocardium. The recently developed fast MR imaging techniques, with the aid of MR contrast media as a perfusion indicator, may be useful in estimating regional myocardial perfusion and blood volume. The assessment of capillary circulation or myocardial perfusion may be used for evaluating the extent of hypoperfusion and treatment efficacy. Experimental and clinical perfusion studies indicate that perfusion-sensitive MR imaging detects compromised myocardium (area at risk). Combining myocardial perfusion imaging with the anatomic and functional information provided by other MR imaging sequences could make MR imaging a comprehensive noninvasive technique for the evaluation of ischemic heart disease.

Animals

Pulmonary hypertension. Response of vasoactive peptides to a nonionic contrast medium in patients undergoing pulmonary angiography.

RATIONALE AND OBJECTIVES: The degree to which pulmonary angiography may contribute to serious complications in patients with pulmonary hypertension has not been clarified and remains a matter of debate. Accordingly, this study was designed (1) to detect the potential release of vasoactive peptides and (2) to investigate the hemodynamic response after administration of a nonionic contrast medium in patients with pulmonary hypertension undergoing pulmonary angiography. Allergy-mediating substances also were measured to monitor for possible anaphylactoid reactions. METHODS: Pulmonary digital subtraction angiography was performed in 20 patients with pulmonary hypertension (mean pulmonary arterial pressure more than 20 mm Hg). Iopromide was administered as a total of 100 mL via a 7F catheter inserted from the right femoral vein. The injected volume and duration of injection (15 to 20 mL/sec) were kept constant. Hemodynamic parameters were continuously monitored, including electrocardiogram, heart rate, phasic and mean pulmonary arterial and peripheral arterial pressures. Blood samples were obtained before and after administration of contrast media to assay for the concentration of the following vasoactive peptides using radioimmunoassay techniques: renin, angiotensin-I-converting enzyme, angiotensin II, aldosterone, atrial natriuretic peptide, antidiuretic hormone, cyclic-guanosine monophosphate, and myoglobin, as well as allergy-mediating substances such as tryptase, eosinophil protein X, and eosinophil cationic protein. RESULTS: Administration of iopromide caused significant increases in atrial natriuretic peptide (from 61.3 +/- 11.8 to 94.0 +/- 16.7) and antidiuretic hormone (from 6.6 +/- 1.9 to 12.3 +/- 3.1), whereas renin significantly decreased (from 3.0 +/- 0.6 to 1.3 +/- 0.5). After administration of contrast media, there were no significant changes in the other measured vasoactive peptides, allergy-mediating substances, and monitored cardiovascular parameters. CONCLUSION: Administration of iopromide for pulmonary angiography in patients with pulmonary hypertension resulted in no appreciable hemodynamic alterations associated with the observed changes in atrial natriuretic peptide, antidiuretic hormone, and renin. No allergy-mediated reactions were observed in these patients.

Adult

Reperfused myocardial infarctions on T1- and susceptibility-enhanced MRI: evidence for loss of compartmentalization of contrast media.

The purpose of this study was to characterize the contrast caused by a susceptibility MRI contrast agents, on spin echo T2-weighted imaging of reperfused myocardial infarction. Our interest in this model focused on the expected requirement that such agents be compartmentalized in the tissue to cause signal loss on spin echo images, a condition which may not be present in reperfused infarcted myocardium. Accordingly, nine rats were subjected to 2 h of left coronary artery occlusion followed by 3 +/- 0.5 h of reperfusion prior to administration of contrast media. Three sets of MR images were acquired: (a) baseline axial images at the midventricle, both T1-weighted (TR/TE = 300/20) and T2-weighted (TR/TE = 1500/60); (b) T1-weighted images after administering a T1-enhancing agent, Gd-DTPA-BMA (0.2 mmol/kg), to document that contrast media is delivered to the reperfused infarction; and (c) T2-weighted images after administering the susceptibility agent, Dy-DTPA-BMA (1.0 mmol/kg). Gadolinium-enhanced T1 images depicted reperfused infarction as regions with greatly enhanced signal intensity compared with uninfarcted myocardium, indicating that contrast agent was delivered to the infarcted zone. Dysprosium-enhanced T2 images depicted the injury as a region of persistent signal intensity relative to depletion of signal in normal myocardium, consistent with failure of the contrast agent to cause signal loss. Similar infarction sizes were observed for unenhanced T2-weighted images (33 +/- 5%), gadolinium-enhanced T1-weighted images (36 +/- 5%) and postmortem staining (30 +/- 6%); strong correlations (r > 0.9) were noted in comparisons of these data.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Inversion recovery EPI of bolus transit in rat myocardium using intravascular and extravascular gadolinium-based MR contrast media: dose effects on peak signal enhancement.

Inversion recovery gradient recalled echo planar imaging (TI/TR/TE = 700/2000/10 ms) was used to dynamically monitor the first pass of an intravascular (GdDOTA-polylysine) and an extravascular (GdDTPA-BMA) contrast agent through normal rat myocardium. It was found that myocardial enhancement increased with dose of the intravascular agent to a limiting value of approximately 50% of fully relaxed intensity, consistent with enhancement of 40% of myocardial water content during the first pass. Larger doses produced no further increase in peak response. On the other hand, the extravascular agent caused incrementally increased enhancement throughout the dose range examined to a final value of 68 +/- 2% of fully relaxed intensity. The profile of dose dependence for both agents was inconsistent with monoexponential T1 relaxation. It was concluded that: (a) compartmentalization of myocardial water combined with restricted myocardial water diffusion limits the peak response during bolus transit; (b) extraction of the extravascular agent during transit elevates the peak response over that obtained from agent confined to the vascular volume; and (c) models that assume simple monoexponential T1 relaxation to derive time-density curves do not adequately describe the relationship between changes in signal intensity, R1 and contrast concentration.

Albumins

Changing practice patterns in peripheral arterial disease.

The development of interventional radiologic techniques during the past decade has changed our approach to the treatment of lower extremity peripheral arterial disease (LE-PAD). Balloon and laser-assisted angioplasty, atherectomy (rotary and directional devices), stent implantation, and thrombolysis as well as combinations of all of these approaches, at times with concomitant or secondary surgery, have been used in our institution. A review of our practice patterns during the past 5 years was performed to analyze changing attitudes and results with these newer techniques. All new patients seen in consultation for LE-PAD during three alternate years were reviewed with regard to demographics, initial complaints, initial treatment modality, initial outcome, indications for and results of secondary treatment, and ultimate outcome (at 1 year). The 603 patients were seen during the following three 12-month periods: 1987 to 1988, 1989 to 1990, and 1991 to 1992. An intention-to-treat analysis revealed (1) the number of patients seen for peripheral arterial disease has increased steadily; (2) in the last year more were initially treated with intervention as the primary modality; (3) the results of such catheter-based procedures improved only slightly over this 5-year period, despite our learning curve and the fact that we discarded several ineffective interventional approaches; (4) the fraction of patients primarily operated on and the excellent results of surgery have not changed; and (5) the number of operations for proximal (aortoiliac) disease has decreased markedly, with a corresponding increase in distal reconstructions. The evolution of our current approach to the treatment of LE-PAD is based on this continuing experience.

Angioplasty, Balloon

AUR Memorial Award. Identification of myocardial cell death in reperfused myocardial injury using dual mechanisms of contrast-enhanced magnetic resonance imaging.

RATIONALE AND OBJECTIVES: Because the magnitude of dysprosium-induced signal loss depends on the microheterogeneity of its distribution (exclusion from intracellular space), we proposed that loss of myocardial cell integrity would be reflected by decreased potency of dysprosium in the injured compared with normal myocardium. We measured the effect of dysprosium on magnetic resonance (MR) imaging signal intensity of reperfused infarcted and nonischemic myocardium and related it to tissue concentration of the contrast media. METHODS: Rats were subjected to 1 hr coronary artery occlusion followed by 1 hr reperfusion. After 45 min of reflow, group 1 (n = 9) received 1.0 and 0.2 mmol/kg dysprosium diethylenetriamine pentaacetic acid-bismethylamide (Dy-DTPA-BMA) and gadodiamide (Gd-DTPA-BMA), respectively. Group 2 (n = 7) received no contrast agents. Excised hearts were imaged with spin-echo T1- and T2-weighted sequences. After imaging, hearts were stained (triphenyltetrazolium chloride) to define the injured zones. Concentrations of Dy-DTPA-BMA and Gd-DPTA-BMA in regional myocardial tissue were determined by induction coupled plasma-atomic emission spectrometry. Separate groups received one or the other contrast medium alone to control for potential error from the mixed effects of the two agents. RESULTS: Gd-DTPA-BMA delineated reperfused infarcted myocardium as a bright zone on T1-weighted images, thus indicating delivery of the agent and reperfusion at the tissue level. Dy-DTPA-BMA delineated the reperfused infarction as a bright region by decreasing the signal intensity of nonischemic myocardium significantly more than that of injured myocardium, despite being present in greater concentration (by 2.46-fold) in the injured myocardium. CONCLUSION: These findings are consistent with the hypothesis that the failure of myocardial cells to exclude the dysprosium compound is responsible for the diminished potency of dysprosium to cause MR imaging signal intensity loss in reperfused myocardial infarction. The combination of the two contrast media may define reperfusion of the myocardium at the tissue level (Gadolinium distribution) and the presence and extent of myocardial necrosis (diminished dysprosium effect) in reperfused myocardial infarctions.

Animals

Comparison of cardiovascular response to ionic and nonionic magnetic resonance susceptibility contrast agents.

RATIONALE AND OBJECTIVES: Bolus injection of magnetic resonance (MR) contrast media has been used in recent years to exploit the diagnostic advantage of newer fast MR imaging sequences. The bolus effects of three equimolar dosages of ionic and nonionic magnetic susceptibility contrast agents on several cardiovascular functional parameters are investigated in normal rats and in rats subjected to acute myocardial infarction. These results are related to the osmolalities of the injected solutions. METHODS: Four groups of rats were examined (n = 10 rats per group). Twenty normal rats were studied. Acute myocardial infarction was produced by ligating the anterior branch of the left coronary artery for 2 hours in another 20 rats. Sequential equimolar doses of 0.1, 0.3, and 0.5 mmol/kg of ionic dysprosium diethylenetriamine pentaacetic acid dimeglumine ([NMG]2DyDTPA) or nonionic dysporosium diethylenetriamine pentaacetic acid-bis-methylamide (DyDTPA-BMA) (sprodiamide injection) were administered intravenously into the left jugular vein as a bolus. Hemodynamic parameters (heart rate, left ventricular pressures, rate of rise of left ventricular pressure [+/- dP/dt], and electrocardiogram as well as central and peripheral pressures) were continuously monitored for 15 minutes after each dose. Left ventricular developed pressure and rate pressure product, as indicators of myocardial oxygen consumption, were calculated. Osmolalities of the injected solutions were determined from freezing-point depression and correlated with the observed hemodynamic alterations. RESULTS: Bolus administration of 0.1, 0.3, and 0.5 mmol/kg DyDTPA-BMA produced no significant effect on the various hemodynamic parameters. (NMG)2DyDTPA caused dose-dependent attenuations in heart rate, left ventricular pressures, +/- dP/dt, rate pressure product and arterial blood pressures in both normal and infarcted rats. The magnitude of the response was dose dependent. Significant correlations were observed between osmolality and peak change of hemodynamic variables (r values between 0.99-1.00) after the administration of (NMG)2DyDTPA, but not after the injection of DyDTPA-BMA. CONCLUSIONS: Bolus administration of (NMG)2DyDTPA resulted in transient negative inotropic and chronotropic effects and hypotension in both healthy and infarcted animals. DyDTPA-BMA, administered as a bolus even at high doses, caused no appreciable hemodynamic alterations.

Animals

The use of contrast-enhanced magnetic resonance imaging to define ischemic injury after reperfusion. Comparison in normal and hypertrophied hearts.

RATIONALE AND OBJECTIVES: Magnetic resonance imaging (MRI) was used to demonstrate the infarction size in reperfused ischemic myocardium of normal and hypertrophied hearts, and to test the hypothesis that hypertrophied hearts manifest greater susceptibility to ischemia. METHODS: Normal rats (n = 11) and rats subjected to left ventricular hypertrophy (LVH) by aortic banding (n = 13) were studied. After 7 weeks, the left coronary artery was occluded for 25 minutes and reperfused for 1 hour before MRI. Electrocardiogram-gated spin-echo images were acquired before and after administration of 0.3 mmol/kg gadoteridol. To quantify the hyperintense area demarcated by gadoteridol, 3 transaxial images were acquired at different levels. Jeopardy and infarcted areas were measured in the same three slices postmortem using blue dye and triphenyltetrazolium chloride (TTC) stain, respectively. RESULTS: Before administration, there was no significant difference in signal intensity between nonischemic (0.42 +/- 0.03 arbitrary units) and ischemic (0.41 +/- 0.03) myocardium in either group. After gadoteridol injection, signal intensity of the reperfused injured region was higher than that of nonischemic myocardium (1.48 +/- 0.16 vs. 0.72 +/- 0.06, P < .05). Magnetic resonance delineation of the hyperintense area persisted for at least 30 minutes. The size of the hyperintense area was larger in LVH than in control hearts (25 +/- 5% vs. 7 +/- 3% of LV surface area, P < .05) and did relate closely to the area of myocardial infarction (r = .97), but not with the jeopardy area (r = .42). On TTC staining, the infarction size also was significantly greater in LVH than in normal group (18 +/- 5% vs. 5 +/- 2% of LV surface area, P < .05). The jeopardy areas of normal and LVH hearts showed no significant difference (46 +/- 2% vs. 47 +/- 3%). CONCLUSION: Magnetic resonance imaging confirms the concept that reperfused myocardial injury is larger in LVH than normal hearts after brief coronary occlusion. Contrast-enhanced MRI can define the size of reperfused myocardial injury. Thus, MRI is a suitable technique to assess conditions accentuating ischemic injury.

Animals

Effect of magnetic susceptibility contrast medium on myocardial signal intensity with fast gradient-recalled echo and spin-echo MR imaging: initial experience in humans.

PURPOSE: To show the effect of dysprosium diethylenetriaminepentaacetic acid bis-methylamine injection on the images of normal human myocardium. MATERIALS AND METHODS: T2-sensitive fast gradient-recalled echo (GRE) (repetition time [TR], 10.8 msec; echo time [TE], 4.2 msec) and spin-echo (SE) (TR, three RR intervals; TE, 60 msec) magnetic resonance (MR) imaging with driven equilibrium-preparation pulse was used to produce T2 contrast material enhancement. The contrast agent was injected into 12 healthy subjects at doses of 0.05, 0.1, 0.2, 0.4, and 0.6 mmol/kg. RESULTS: Driven equilibrium-prepared GRE images showed a transient decrease of myocardial signal intensity at doses of 0.2-0.6 mmol/kg. Postcontrast T2-weighted SE images showed a myocardial signal attenuation (30%-45% decrease) at a dose of 0.4 mmol/kg or higher. CONCLUSION: Dynamic MR imaging with a magnetic susceptibility contrast medium can be used to monitor the first pass of contrast media through human myocardium with a conventional MR imager and a fast GRE sequence.

Adult

Identification of myocardial reperfusion with echo planar magnetic resonance imaging. Discrimination between occlusive and reperfused infarctions.

BACKGROUND: The current treatment of many cases of acute myocardial infarction involves the use of thrombolytic agents. Evaluation of this therapy requires determination of the success of reperfusion and assessment of the presence and extent of infarction in the reperfused territory. The present study was designed to simulate in rat models several possible outcomes of reperfusion therapy: (1) successful reperfusion and absence of myocardial infarction, (2) successful reperfusion and presence of myocardial infarction, and (3) unsuccessful reperfusion. The usefulness of contrast-enhanced fast magnetic resonance (MR) imaging in defining the success of reperfusion was investigated. The dynamic effects were examined of low and high doses of gadolinium-BOPTA/dimeglumine (Gd-BOPTA/dimeg) on myocardial signal using MR inversion recovery echo planar imaging (IR-EPI) and gradient recalled echo planar imaging (GR-EPI), respectively. METHODS AND RESULTS: Rats were subjected to one of the following regimens: reperfused reversible myocardial injury (n = 9), reperfused irreversible myocardial injury (n = 9), and occlusive infarction (n = 9). MR echo planar images were acquired every 1 or 2 seconds before, during, and after administration of Gd-BOPTA/dimeg. In all groups, normal myocardial signal was sharply increased on IR-EPI and decreased on GR-EPI at the peak of the bolus, followed by a gradual decline to baseline. In animals subjected to reperfused reversible myocardial injury, normal and previously ischemic regions were indistinguishable during and after the passage of Gd-BOPTA/dimeg. On the other hand, enhancement of reperfused irreversibly injured myocardium was delayed but increased steadily to a higher level than normal myocardium on IR-EPI. The reperfused irreversibly injured myocardium was identified on IR-EPI as a zone of high signal (hot spot). On GR-EPI, signal loss in reperfused irreversibly injured myocardium was significantly less compared with normally perfused myocardium. In animals with occlusive infarctions, there was no change in signal intensity over the ischemic region on either IR-EPI or GR-EPI. Occlusive infarction was identified as zones of either low (cold spot) or high (hot spot) signal compared with normal myocardium, depending on MR pulse sequence and dose of the contrast medium. CONCLUSIONS: The transit of Gd-BOPTA/dimeg monitored by fast MR imaging techniques can be used to distinguish between reperfused reversibly and reperfused irreversibly injured myocardium and between occlusive and reperfused infarctions.

Animals