VALUE OF GADOLINIUM-DIETHYLENE-TRIAMINE PENTAACETIC ACID DYNAMICS IN MAGNETIC-RESONANCE-IMAGING OF ACUTE MYOCARDIAL-INFARCTION WITH OCCLUDED AND REPERFUSED CORONARY-ARTERIES AFTER THROMBOLYSIS

The use of the paramagnetic contrast agent gadolinium-diethylene-triamine pentaacetic acid (DTPA) was evaluated in magnetic resonance imaging (MRI) of 18 patients with an acute myocardial infarction after thrombolysis. The patency of the infarct-related vessel was assessed by coronary angiography. At 58 ± 9 hours after infarction MRI was performed before and after bolus injection of 0.1 mmol/kg gadolinium-DTPA. Myocardial signal intensities were measured using a circumferential profile. Normal and infarcted myocardium showed a maximum signal intensity enhancement of 35 and 66%, respectively. Signal intensity of infarcted relative to normal myocardium ( I N) increased from 1.06 ± 0.16 before to a maximum of 1.39 ± 0.13 after gadolinium-DTPA (p < 0.001), whereas the contrast between normal myocardium and a pseudo-infarct region in 2 healthy volunteers did not change. Between patients with reperfused infarctrelated vessels and occluded vessels without collaterals, maximum I N did not differ. However, observing I N as a function of time after injection of gadolinium-DTPA, the reperfusion group differed from the occlusion group on images acquired directly after injection (1.29 ± 0.10 vs 1.14 ± 0.05, p < 0.02). Thus, gadolinium-DTPA enhanced the visualization of acute myocardial infarction on relatively longitudinal (T1)-weighted MR images and its dynamics seem of potential value for the noninvasive assessment of coronary artery reperfusion after thrombolysis. © 1990.