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新型钆基磁共振造影剂P846在缺血性损伤心肌中的动力学的磁共振成像评估。

MR imaging assessment of the kinetics of P846, a new gadolinium-based MR contrast medium, in ischemically injured myocardium.

作者信息

Jacquier Alexis, Wendland Michael, Do Loi, Robert Philippe, Corot Claire, Higgins Charles B, Saeed Maythem

机构信息

Department of Radiology, University of California San Francisco, CA 94134-0628, USA.

出版信息

Contrast Media Mol Imaging. 2008 May-Jun;3(3):112-9. doi: 10.1002/cmmi.237.

Abstract

The objectives of the study were: (1) to compare the kinetics of a new gadolinium-based low-diffusibility magnetic resonance (MR) contrast medium, P846 and Gd-DOTA in left ventricular (LV) blood and in normal and ischemically injured myocardium using inversion recovery echo-planar imaging (IR-EPI) and (2) to compare the enhancement pattern after injection of P846 with Gd-DOTA, using T1-weighted spin-echo imaging (T1-SE). Sixteen rats were subjected to left descending artery (LAD) occlusion for 30 min, followed by 2.5 h reperfusion. MR imaging was performed before and after administration of the contrast medium in two different groups of animals: one group (n = 8) received 0.05 mmol kg(-1) P846 and the other (n = 8) 0.1 mmol kg(-1) Gd-DOTA. A blipped IR-EPI and a multislice T1-SE were performed before injection and for 90 min after injection. T1-values were derived by fitting regional signal intensity on the IR-EPI images, the R1, DeltaR1 (R(1postcontrast) - R(1precontrast)) and DeltaR1 ratios were calculated in LV blood, normal and injured myocardium. On SE-T(1), the signal intensity ratio (SI) and extent of injury were measured. True infarct size was measured using histochemical staining. Changes in DeltaR(1) were 4.8 times greater with 0.05 mmol kg(-1) P846 than with 0.1 mmol kg(-1) Gd-DOTA in LV blood (6.3 +/- 0.9 vs 0.9 +/- 0.1 s(-1), p < 0.0001), normal (1.7 +/- 0.2 vs 0.34 +/- 0.03 s(-1), p < 0.0001) and ischemically injured myocardium (5.4 +/- 0.4 vs 1.6 +/- 0.1 s(-1), p < 0.0001). MR imaging experiments showed that the signal enhancement with P846 is longer (90 min), which might be explained by a lower diffusion of P846 compared with Gd-DOTA (30 min). P846 differentiates viable and nonviable myocardium. Despite lower gadolinium dose, P846 permits differentiation of viable and nonviable myocardium owing to a high contrast and a long imaging window with conventional t1-weighted SE sequence.

摘要

本研究的目的是

(1)使用反转恢复回波平面成像(IR-EPI)比较一种新型钆基低扩散性磁共振(MR)造影剂P846和钆喷酸葡胺(Gd-DOTA)在左心室(LV)血液以及正常和缺血损伤心肌中的动力学;(2)使用T1加权自旋回波成像(T1-SE)比较注射P846和Gd-DOTA后的增强模式。16只大鼠左冠状动脉前降支(LAD)闭塞30分钟,随后再灌注2.5小时。在两组不同的动物中于给予造影剂前后进行MR成像:一组(n = 8)接受0.05 mmol kg⁻¹ P846,另一组(n = 8)接受0.1 mmol kg⁻¹ Gd-DOTA。在注射前以及注射后90分钟进行快速小角度激发IR-EPI和多层T1-SE检查。通过拟合IR-EPI图像上的局部信号强度得出T1值,计算LV血液、正常和损伤心肌中的R1、ΔR1(造影剂注射后R1 - 造影剂注射前R1)和ΔR1比率。在SE-T1上,测量信号强度比(SI)和损伤范围。使用组织化学染色测量实际梗死面积。在LV血液中,0.05 mmol kg⁻¹ P846引起的ΔR1变化比0.1 mmol kg⁻¹ Gd-DOTA大4.8倍(6.3 ± 0.9对0.9 ± 0.1 s⁻¹,p < 0.0001),在正常心肌中(1.7 ± 0.2对0.34 ± 0.03 s⁻¹,p < 0.0001)以及缺血损伤心肌中(5.4 ± 0.4对1.6 ± 0.1 s⁻¹,p < 0.0001)。MR成像实验表明,P846引起的信号增强持续时间更长(90分钟),这可能是因为与Gd-DOTA(30分钟)相比,P846的扩散性较低。P846能够区分存活心肌和坏死心肌。尽管钆剂量较低,但由于对比度高且使用传统T1加权SE序列时有较长的成像窗口,P846仍能区分存活心肌和坏死心肌。

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