Assessment of myocardial infarction and postinfarction scar remodeling with an elastin-specific magnetic resonance agent.

BACKGROUND: To prospectively evaluate an elastin-specific MR contrast agent (ESMA) for in vivo targeting of elastic fibers in myocardial infarction (MI) and postinfarction scar remodeling. METHODS AND RESULTS: MI was induced in C57BL/6J mice (n=40) by permanent ligation of the left anterior descending coronary artery. MRI was performed at 7 and 21 days after MI. The merits of gadolinium-based ESMA (Gd-ESMA) were compared with gadopentetic acid (Gd-DTPA) for infarct size determination, contrast-to-noise ratio (CNR), and enhancement kinetics. Specific binding in vivo was evaluated by blocking the molecular target using nonparamagnetic lanthanum-ESMA. In vivo imaging results were confirmed by postmortem triphenyltetrazolium chloride staining, elastica van Gieson staining, and Western blotting. Delayed enhancement MRI revealed prolonged enhancement of Gd-ESMA in the postischemic scar compared with Gd-DTPA. Infarct size measurements showed good agreement between Gd-ESMA and Gd-DTPA and were confirmed by ex vivo triphenyltetrazolium chloride staining. Preinjection of the blocking lanthanum-ESMA resulted in significantly lower CNR of Gd-ESMA at the infarct site (P=0.0019). Although no significant differences in CNR were observed between delayed enhancement imaging and Gd-DTPA between days 7 and 21 (1.8± versus 3.8; P=ns), Gd-ESMA showed markedly higher CNR on day 21 after MI (14.1 versus 4.9; P=0.0032), which correlated with increased synthesis of tropoelastin detected by Western blot analysis and histology. Higher CNR values for Gd-ESMA further correlated with improved ejection fraction of the mice on day 21 after MI. CONCLUSIONS: Gd-ESMA enables targeting of elastin within the infarct scar in a mouse model of MI. The imaging properties of Gd-ESMA allow quantification of intrascar elastin content in vivo and thereby provide potential for noninvasive characterization of postinfarction scar remodeling.

Evaluation of phase-sensitive versus magnitude reconstructed inversion recovery imaging for the assessment of myocardial infarction in mice with a clinical magnetic resonance scanner.

PURPOSE: To evaluate phase-sensitive inversion-recovery (PSIR) imaging at 1.5 T in a mouse model of permanent coronary artery ligation as a potentially rapid and robust alternative for the accurate assessment of myocardial infarction (MI) by cardiac magnetic resonance imaging (MRI). MATERIALS AND METHODS: PSIR late gadolinium enhancement (LGE) imaging was compared to conventional 2D segmented inversion-recovery imaging for the assessment of murine MI. RESULTS: PSIR images provided comparable contrast and kinetics of intravenously injected gadopentetate dimeglumine (Gd-DTPA). At the mid-ventricular level there was good agreement between conventional IR and PSIR for infarct size assessment. After intravenous injection a limited time window of ∼6 minutes is available for delayed enhancement imaging in mice. Whole-heart infarct imaging with 1 mm thick slices was only possible in this restricted time frame when the PSIR method is applied, avoiding the need for repetitively adapting the correct inversion time. Infarct size determined by PSIR MRI demonstrated good agreement with postmortem histology. Infarct size determined by PSIR LGE MRI inversely correlates with left-ventricular function on day 7 after MI. CONCLUSION: The PSIR technique provides stable and consistent contrast between hyperenhanced and remote myocardium independent of the selected inversion time (TI) and proved to be a robust, fast, and accurate tool for the assessment of MI in mice.

Assessment of Myocardial Viability with 3D MRI at 3 T.

OBJECTIVE: The aim of our study was to show that spatial resolution can be improved without loss of diagnostic accuracy if a 3D inversion recovery gradient-recalled echo (GRE) sequence is used instead of a segmented inversion recovery GRE at 3 T for the assessment of myocardial infarction. SUBJECTS AND METHODS: Fifteen patients with myocardial infarction were examined on a 3-T MR system. A segmented breath-hold 3D inversion recovery GRE technique with a voxel size of 6.3 mm(3) was compared with a breath-hold standard 2D inversion recovery GRE technique with a voxel size of 21.3 mm(3) for the detection of delayed enhancement. Contrast-to-noise ratios (CNRs) were calculated and infarct volumes were measured. Detection and transmural extent of infarctions were evaluated using kappa statistics. Total acquisition times were measured for both sequences. RESULTS: The CNR in the 3D technique did not show any significant difference compared with the 2D technique. The correlation coefficients of the infarct volumes determined with the 3D and 2D inversion recovery GRE studies at 3 T were r = 0.99 (p < 0.001). The assessment of the presence of hyperenhanced myocardium in all segments and the evaluation of transmurality resulted in very good agreement (kappa = 0.98 and kappa = 0.90). Total acquisition time was significantly shorter with the 3D technique (2.4 +/- 0.9 minutes) than with the 2D technique (4.9 +/- 1.5 minutes) (p < 0.001). CONCLUSION: The use of a 3D inversion recovery GRE sequence at 3 T allows accurate assessment of myocardial infarction without loss of CNR compared with the standard 2D technique. Furthermore, data acquisition time can be significantly reduced.