Doeblin Patrick, Schilling Rene, Wagner Moritz, Luhur Reny, Huppertz Alexander, Hamm Bernd, Taupitz Matthias, Durmus Tahir
Department of Cardiology, Charité - Universitätsmedizin Berlin, Charité Campus Benjamin Franklin, Berlin, Germany.
Department of Radiology, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany.
Eur J Radiol. 2014 Apr;83(4):660-4. doi: 10.1016/j.ejrad.2013.12.019. Epub 2013 Dec 27.
To evaluate T1-relaxation times of chronic myocardial infarction (CMI) using gadobutrol and gadopentetate dimeglumine (Gd-DTPA) over time and to determine the optimal imaging window for late enhancement imaging with both contrast agents.
Twelve patients with CMI were prospectively included and examined on a 1.5 T magnetic resonance (MR) system using relaxivity-adjusted doses of gadobutrol (0.15 mmol/kg) and Gd-DTPA (0.2 mmol/kg) in random order. T1-relaxation times of remote myocardium (RM), infarcted myocardium (IM), and left ventricular cavity (LVC) were assessed from short-axis TI scout imaging using the Look-Locker approach and compared intraindividually using a Wilcoxon paired signed-rank test (α<0.05).
Within 3 min of contrast agent administration (CA), IM showed significantly lower T1-relaxation times than RM with both contrast agents, indicating beginning cardiac late enhancement. Differences between gadobutrol and Gd-DTPA in T1-relaxation times of IM and RM were statistically not significant through all time points. However, gadobutrol led to significantly higher T1-relaxation times of LVC than Gd-DTPA from 6 to 9 min (220 ± 15 ms vs. 195 ± 30 ms p<0.01) onwards, resulting in a significantly greater ΔT1 of IM to LVC at 9-12 min (-20 ± 35 ms vs. 0 ± 35 ms, p<0.05) and 12-15 min (-25 ± 45 ms vs. -10 ± 60 ms, p<0.05). Using Gd-DTPA, comparable ΔT1 values were reached only after 25-35 min.
This study indicates good delineation of IM to RM with both contrast agents as early as 3 min after administration. However, we found significant differences in T1 relaxation times with greater ΔT1 IM-LVC using 0.15 mmol/kg gadobutrol compared to 0.20 mmol/kg Gd-DTPA after 9-15 min post-CA suggesting earlier differentiability of IM and LVC using gadobutrol.
使用钆布醇和钆喷酸葡胺(Gd-DTPA)随时间评估慢性心肌梗死(CMI)的T1弛豫时间,并确定两种造影剂延迟强化成像的最佳成像窗口。
前瞻性纳入12例CMI患者,在1.5T磁共振(MR)系统上采用弛豫率调整剂量的钆布醇(0.15 mmol/kg)和Gd-DTPA(0.2 mmol/kg),随机顺序进行检查。使用Look-Locker方法从短轴TI预扫描成像评估远心肌(RM)、梗死心肌(IM)和左心室腔(LVC)的T1弛豫时间,并使用Wilcoxon配对符号秩检验进行个体内比较(α<0.05)。
在注射造影剂(CA)后3分钟内,两种造影剂的IM的T1弛豫时间均显著低于RM,表明开始出现心脏延迟强化。在所有时间点,钆布醇和Gd-DTPA在IM和RM的T1弛豫时间上的差异无统计学意义。然而,从6到9分钟起,钆布醇导致LVC的T1弛豫时间显著高于Gd-DTPA(220±15毫秒对195±30毫秒,p<0.01),导致在9 - 12分钟(-20±35毫秒对0±35毫秒,p<0.05)和12 - 15分钟(-25±45毫秒对-10±60毫秒,p<0.05)时IM与LVC的ΔT1显著更大。使用Gd-DTPA时,仅在25 - 35分钟后才达到可比的ΔT1值。
本研究表明,两种造影剂在给药后3分钟即可很好地区分IM和RM。然而,我们发现,与0.20 mmol/kg Gd-DTPA相比,使用0.15 mmol/kg钆布醇在CA后9 - 15分钟时T1弛豫时间存在显著差异,IM - LVC的ΔT1更大,这表明使用钆布醇时IM和LVC的区分更早。