Contrast media for cardiothoracic MR imaging

Higgins, Charles B.; Saeed, Maythem; Wendland, Michael F.; Yu, Kyle K.; Lauerma, Kirsi; Dulce, M C; Kanth, Nalini

doi:10.1002/jmri.1880030138

Cited by 20 publications

(10 citation statements)

References 21 publications

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“…Within the ith pathway, the content, q i (t), is (3) whore R MVi (t) is the residue function for the ith pathway, representing the fraction of the indicator retained in the system at time t for an impulse input to the pathway. Convolving the actual input C LV (t) with R MVi (t) and weighting by the relative flow f i and fractional mass w i gives the content q i (t).…”

Section: Mr Blood Flow Estimatesmentioning

confidence: 99%

“…A variety of intravascular and extracellular MR contrast agents have been studied for delineation of infarcted myocardium (1)(2)(3) and for identification of acutely ischemic and reperfused cardiac muscle (4,5). The first-pass MR imaging technique with the extracellular contrast agent gadolinium diethylenetriaminepentaacetic acid (DTPA) has been used to assess myocardial perfusion in patients at rest (6,7) and during pharmacologic stress (8,9).…”

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Regional myocardial blood volume and flow: First‐pass MR imaging with polylysine‐Gd‐DTPA

Wilke

Kroll

Merkle

et al. 1995

Magnetic Resonance Imaging

132

104

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The authors investigated the utility of an intravascular magnetic resonance (MR) contrast agent, poly-L-lysine-gadolinium diethylenetriaminepentaacetic acid (DTPA), for differentiating acutely ischemic from normally perfused myocardium with first-pass MR imaging. Hypoperfused regions, identified with microspheres, on the first-pass images displayed significantly decreased signal intensities compared with normally perfused myocardium (P < .0007). Estimates of regional myocardial blood content, obtained by measuring the ratio of areas under the signal intensityversus-time curves in tissue regions and the left ventricular chamber, averaged 0.12 mL/g ± 0.04 (n = 35), compared with a value of 0.11 mL/g ± 0.05 measured with radiolabeled albumin in the same tissue regions. To obtain MR estimates of regional myocardial blood flow, in situ calibration curves were used to transform first-pass intensity-time curves into content-time curves for analysis with a multiple-pathway, axially distributed model. Flow estimates, obtained by automated parameter optimization, averaged 1.2 mL/min/g ± 0.5 [n = 29), compared with 1.3 mL/min/g ± 0.3 obtained with tracer microspheres in the same tissue specimens at the same time. The results represent a combination of T1-weighted first-pass imaging, intravascular relaxation agents, and a spatially distributed perfusion model to obtain absolute regional myocardial blood flow and volume. Index termsContrast agent, blood pool; Contrast enhancement; Coronary vessels, diseases, 54.76; Heart, flow dynamics; Heart, MR, 51.12143; Model, mathematical; Myocardium, blood supply, 511.12143; Myocardium, MR, 511.12143 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptA growing body of evidence supports the feasibility of evaluating myocardial perfusion with magnetic resonance (MR) imaging with contrast agents. A variety of intravascular and extracellular MR contrast agents have been studied for delineation of infarcted myocardium (1-3) and for identification of acutely ischemic and reperfused cardiac muscle (4,5). The first-pass MR imaging technique with the extracellular contrast agent gadolinium diethylenetriaminepentaacetic acid (DTPA) has been used to assess myocardial perfusion in patients at rest (6,7) and during pharmacologic stress (8,9). Although experimental (10) and patient studies have demonstrated the suitability of extracellular contrast agents for detecting hypoperfused myocardium, such agents are inherently disadvantageous for flow quantification because they are not confined to a single volume compartment within the tissue. Consequently, first-pass kinetics of an extracellular agent are determined not only by blood flow but by the intravascular and interstitial distribution volumes and by permeability across the capillary wall. This exchange between the vascular and interstitial compartments greatly complicates quantification of tissue blood flow unless it is either very fast or slow compared with flow rates (11).The objective of the present study was to...

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Section: Mr Blood Flow Estimatesmentioning

confidence: 99%

mentioning

confidence: 99%

Regional myocardial blood volume and flow: First‐pass MR imaging with polylysine‐Gd‐DTPA

Wilke

Kroll

Merkle

et al. 1995

Magnetic Resonance Imaging

132

104

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“…The use of contrast agents in cardiac MRI has been studied for many years (12,(31)(32)(33)(34). Several studies have evaluated the use of T1-shortening contrast agents in combination with MRI to characterize regional tissue perfusion, ischemia, and infarction (35,36).…”

Section: Contrast Mediamentioning

confidence: 99%

Assessment of myocardial viability by MRI

Bax

Roos

Wall

1999

J. Magn. Reson. Imaging

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“…The contrast agent passes rapidly through the right and left ventricular cavity and then into the myocardium causing alterations of signal intensity (Figure 1). Schlüsselwörter: Magnetresonanztomographie · Myokardperfusion · Koronare Herzerkrankung gadolinium-DTPA, lead mainly to shortening of T1 relaxation resulting in an increase of signal intensity during the passage through the myocardium [29,48], while T2 shortening, or susceptibility contrast agents, cause local magnetic field disturbances leading to a decrease of signal [6,65]. Most data is available on the use of T1 shortening contrast agents, which are currently most promising for a rapid introduction into the clinical assessment of patients, thus, they are mainly described in the text.…”

Section: Mr Perfusion With Contrast Agentsmentioning

confidence: 99%

Cardiovascular Magnetic Resonance: Myocardial Perfusion

Nagel¹,

Al-Saadi²,

Fleck

2000

Herz

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There is growing evidence that the noninvasive assessment of myocardial perfusion with cardiovascular magnetic resonance is a valid and accurate tool for the assessment of ischemic heart disease and its introduction into routine clinical evaluation of patients is rapidly expected. Magnetic resonance measurements allow the evaluation of reversible and irreversible myocardial ischemia, the assessment of acute myocardial infarction, as well as the recognition and detection of viable myocardium. Magnetic resonance perfusion measurements are mainly performed with T1-shortening contrast agents such as gadolinium-DTPA either by visual analysis or based on the analyses of signal intensity time curves. For the detection of myocardial ischemia the first pass kinetics of a gadolinium-DTPA bolus and for the detection of myocardial necrosis and the definition of viable myocardium steady state distribution kinetics are assessed. Quantitative analysis of myocardial perfusion can be performed but requires complex modeling due to the characteristics of gadolinium-DTPA. Thus, semi-quantitative parameters are preferred. There is accumulating evidence in the literature that magnetic resonance imaging can be used for the detection of coronary artery stenosis with high diagnostic accuracy both with semi-quantitative or visual analysis. Myocardial infarction can be reliably detected and the infarcted area determined. Non-reperfused infarcted myocardium can be differentiated from reperfused myocardium by different enhancement patterns that correlates with viability. Cardiac magnetic resonance is a promising technique that can combine different functional studies during one examination, such as the assessment of wall motion and perfusion at rest and stress. With further improvements in analysis software magnetic resonance perfusion measurement may rapidly become a routine tool for the assessment of patients with coronary artery disease.

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Contrast media for cardiothoracic MR imaging

Cited by 20 publications

References 21 publications

Regional myocardial blood volume and flow: First‐pass MR imaging with polylysine‐Gd‐DTPA

Regional myocardial blood volume and flow: First‐pass MR imaging with polylysine‐Gd‐DTPA

Assessment of myocardial viability by MRI

Cardiovascular Magnetic Resonance: Myocardial Perfusion

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