Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Evaluation by Contrast-Enhanced MR Imaging of the Lateral Border Zone in Reperfused Myocardial Infarction in a Cat Model

  • Ae Kyung Jeong (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sang Il Choi (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Dong Hun Kim (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sung Bin Park (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Seoung Soo Lee (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Seong Hoon Choi (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Tae-Hwan Lim (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2000.06.21
  • Accepted : 2000.12.07
  • Published : 2001.03.31
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Abstract

Objective: To identify and evaluate the lateral border zone by comparing the size and distribution of the abnormal signal area demonstrated by MR imaging with the infarct area revealed by pathological examination in a reperfused myocardial infarction cat model. Materials and Methods: In eight cats, the left anterior descending coronary artery was occluded for 90 minutes, and this was followed by 90 minutes of reperfusion. ECG-triggered breath-hold turbo spin-echo T2-weighted MR images were initially obtained along the short axis of the heart before the administration of contrast media. After the injection of Gadomer-17 and Gadophrin-2, contrast-enhanced T1-weighted MR images were obtained for three hours. The size of the abnormal signal area seen on each image was compared with that of the infarct area after TTC staining. To assess ultrastructural changes in the myocardium at the infarct area, lateral border zone and normal myocardium, electron microscopic examination was performed. Results: The high signal area seen on T2-weighted images and the enhanced area seen on Gadomer-17-enhanced T1WI were larger than the enhanced area on Gadophrin-2-enhanced T1WI and the infarct area revealed by TTC staining; the difference was expressed as a percentage of the size of the total left ventricle mass (T2= 39.2 %; Gadomer-17 =37.25 % vs Gadophrin-2 = 29.6 %; TTC staining = 28.2 %; p < 0.05). The ultrastructural changes seen at the lateral border zone were compatible with reversible myocardial damage. Conclusion: In a reperfused myocardial infarction cat model, the presence and size of the lateral border zone can be determined by means of Gadomer-17- and Gadophrin-2-enhanced MR imaging.

Keywords

Acknowledgement

The authors wish to thank Chung-Hwan Lim, BS, Department of Radiology, Asan Medical Center, for his technical assistance in conducting MRI with animals, and Schering A.G., Berlin, Germany, for providing Gadophrin-2 and Gadomer-17.

References

  1. Wackers FJ, Bodenheimer M, Fleiss JL, Brown M. Factors affecting uniformity in interpretation of planar thallium-201 imaging in a multicenter trial. The Multicenter Study on Silent Myocardial Ischemia(MSSMI) Thallium-201 Investigator. J Am Coll Cardiol 1993;21:1064-1074
  2. Klocke FJ. Measurements of coronary blood flow and degree of stenosis : current clinical implications and continuing uncertainties. J Am Coll Cardiol 1983;1:31-41
  3. Ni Y, Marchal G, Yu J, et al. Localization of metalloporphyrin - induced "specific" enhancement in experimental liver tumors: Comparison of MRI, microangiographic and histologic findings. Acad Radiol 1995;2:687-699
  4. Hindre F, LePlouzennec M, De Certaines JD, et al. Tetra-pamonophenylporphyrin-conjugated Gd-DTPA: Tumor-specific contrast agent for MR imaging. J Magn Reson Imaging 1993;3(1):59-65
  5. Young SW, Sidhu MK, Qing F, et al. Preclinical evaluation of gadolinium texaphyrin complex: a new paramagnetic contrast agent for magnetic resonance imaging. Invest Radiol 1994;29:330-338
  6. Ni Y, Marchal G, Herijgers P, et al. Paramagnetic metalloporphyrins: from enhancers of malignant tumors to markers of myocardial infarcts. Acta Radiol 1996;3(2):395-397
  7. Noh HN, Choi SI, Choi SH, et al. Gadomer-17 in contrast enhanced MR imaging of reperfused myocardial infarction in a cat model. J Kor Radiol Soc 2000;43:539-544
  8. Weinmann HJ, Brasch RC, Press WR, Wesby GE. Characteristics of gadolinium-DTPA complex: a potential NMR contrast agent. AJR 1984;142:619-624
  9. Saeed M, Wendland MF, Yu KK, Li HT, Higgins CB. Dual effects of gadodiamide injection in depiction of the region of myocardial ischemia. J Magn Reson Imaging 1993;3:21-29
  10. Muller RN, Vander Elst L, Colet JM, et al. Spectroscopic monitoring of the cellular internalization of paramagnetic ions and their complexes: a perfused cells and perfused organs approach. Acad Radiol 1996;3(suppl. 2):277-281
  11. Watson AD, Rocklage SM, Carvlin MJ. Contrast agents. In Stark DD, Bradley WG Jr, eds. Magnetic resonance imaging, 2nd ed. St Louis, MO: Mosby, 1992: 372-437
  12. Ni Y, Marchal G, Yu J, et al. Localization of metalloporphyrin-induced specific enhancement in experimental liver tumors: comparison of MRI, microangiographic and histologic findings. Acad Radiol 1995;2:687-699
  13. Jennings RB, Steenberger C, Reiner KA. Myocardial ischemia and reperfusion. In Schien FJ, Gimbrone MA, eds. Cardiovascular pathology, 1st ed. Baltmore, MD: Williams & Wilkins, 1995:58-64
  14. Braunwald E. Myocardial reperfusion, limitation of infarct size, reduction of left ventricular dysfunction, and improved survival. Should the paradigm be expanded? Circulation 1989;79:441-444
  15. Whiteman G, Kieval R, Wetstein L, et al. The relationship between global myocardial redox state and high-energy phosphate profile: a phosphorus-31 nuclear magnetic resonance study. J Sur Res 1983;35:339
  16. Reimer KA, Lowe JE, Rasmussen MM, Jennings RB. The "wavefront phenomenon" of ischemic cell death. I: Myocardial infarct size vs duration of coronary occlusion in dogs. Circulation 1977;56:786-794
  17. Reimer KA, Jennings RB: The "wavefront phenomenon" of myocardial ischemic cell death. II: transmural progression of necrosis within the framework of ischemic bed size(myocardium at risk) and collateral flow. Lab Invest 1979;40:634-644
  18. Maxwell SR, Lip GY. Reperfusion injury: a review of the pathophysiology, clinical manifestations and therapeutic options. Int J Card 1997;58:95-117
  19. Jennings RB, Reimer KA. Factors involved in salvaging ischemic myocardium: effect of reperfusion of arterial blood. Circulation 1983;68:25-36
  20. Rivas F, Cobb FR, Bache RJ, Grrenfield JC. Relationship between blood flow to ischemic regions and extent of myocardial infarction. Circ Res 1976;38:439-447
  21. Jugdutt BI, Hutchins GM, Bulkey BH, Pitt B, Becker LC. Effect of indomethacin on collateral blood flow and infarct size in the conscious dog. Circulation 1979;734-743
  22. Gottlieb GJ, Kudo SH, Alonso DR. Ultrastructural characterization of the border zone surrounding early experimental myocardial infarctions in dogs. Am J Pathol 1981;103:292-303
  23. Yellon DM, Hearse DJ, Crone R, Granelle J. Characterization of the lateral interface between normal and ischemic tissue in the canine heart during evolving myocardial infarction. Am J Cardiol 1981;47:1233-1239
  24. Factor SM, Okun EM, Kirk ES. The histological lateral border of acute canine myocardial infarction. Circ Res 1981;48:640-649
  25. Lim T-H, Hong MK, Lee JS, et al. Novel application of breathhold turbo spin-echo T2 MRI for detection of acute myocardial infarction. J Magn Reson Imaging 1997;7:996-1001
  26. Johnston D, Thompston R, Liu P. Magnetic resonance imaging during acute myocardial infarction. Am J Cardiol 1986;58:214-219
  27. Adzamli IK, Blau M, Pfeffer MA, Bavis MA. Phosphonate-modified Gd-DTPA complexes. III: the detection of myocardial infarction by MRI. Magn Reson Med 1993;29:505-511
  28. De Roos A, Matheijssen NA, Doornbos J, et al. Myocardial infarct size after reperfusion therapy: assessment with Ga-DTPA-enhanced MR imaging. Radiology 1990;176:517-521
  29. Saeed M, Wendland MF, Matusi T, Higgins CB. Reperfused myocardial infarction on T1- and susceptibility-enhanced MRI: evidence of loss compartmentalization contrast media. Magn Reson Med 1994;31:31-39
  30. Judd RM, Lugo OC, Aria M, et al. Physiological basis of myocardial contrast enhancement in fast magnetic resonance imaging of 2-day-old reperfused canine infarct. Circulation 1995;92:1902-1910
  31. Lim T-H, Lee JH, Lee TK, Mun CW. Comparison of gadolinium polylysine and gadopentetate in contrast-enhanced MR imaging of myocardial ischemia-reperfusion in cats. J Kor Radiol Soc 1995;33:59-65
  32. Choi SH, Jiang CZ, Lee TK, et al. Myocardial assessment during subacute stage after ischemia-reperfusion: Gd-DTPA-polylysine enhanced MR imaging in cats. J Kor Radiol Soc 1998;39:1069-1073
  33. Marchal G, Ni Y, Flameng W, et al. Paramagnetic metalloporphyrin: infarct-avid contrast agents for diagnosis of acute myocardial infarction by MRI. Eur Radiology 1996;6:2-8
  34. Choi SI, Choi SH, Kim ST, et al. Irreversibly damaged myocardium at MR imaging with a necrotic tissue-specific contrast agent in a cat model. Radiology 2000;215:863-868