Assessment of hepatic portal perfusion using T2 measurements of Gd-DTPA.

Recently, perfusion imaging has been of increasing interest in MRI. We applied this method for semiquantitative evaluation of hepatic parenchymal portal blood flow in patients with diffuse liver damage. Twenty patients with diffuse hepatic damage were divided according to the Child's Classification and studied. Gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) was administered into the superior mesenteric artery (SMA), and a dynamic series of T2*-weighted fast low angle shot (FLASH) images was obtained. We evaluated relative regional portal blood volume (rrPBV), mean transit time (MTT), and relative regional portal blood flow (rrPBF). The relationship between the rrPBV, rrPBF, and plasma indocyanine green retention rate test at 15 minutes (ICGR15 was also evaluated in 12 patients. Both rrPBF and rrPBV are significantly decreased in Child B & C patients compared with Child A patients. On the other hand, the MTT is significantly prolonged in Child B & C patients compared with Child A patients. Significant correlations were also noted between rrPBV and ICGR15 and between rrPBF and ICGR15. By means of selective catheterization into the SMA, we were able to estimate rrPBV, rrPBF, and MTT. This method may play a clinical role for assessment of regional portal perfusion in various diseases with diffuse liver damage.

Diagnostic value of body surface map in myocardial infarction: assessment of location, size and ejection fraction as compared with coronary cineangiography and 201Tl myocardial scintigraphy.

The diagnosis of the location and size of old myocardial infarction was made by the map and various indices obtained from the map were correlated with coronary arteriography, left ventriculography, and 201Tl myocardial scintigraphy. Diseased coronary arteries were presumed from Q30, Q40 area and/or peak voltage map and left ventricular wall motion was estimated from subtraction map. There were significant correlations between ejection fraction and sigma R in anterolateral MI (r = 0.51, p less than 0.001) and between ejection fraction and nQ30 in anterolateral (r = -0.47, p less than 0.001) and inferoposterior (r = -0.63, p less than 0.01) MI. Negative correlation was observed between myocardial uptake ratio (MUR) and nQ30 (r = -0.69, p less than 0.001) and positive correlation between MUR and sigma R (r = 0.50 p less than 0.01) in anterolateral MI. Those cases which could not be diagnosed by either ECG or 201Tl scintigraphy were correctly diagnosed by the map and it proved to have an excellent diagnostic accuracy for myocardial infarction.