Intrinsic contrast for characterization of acute radiofrequency ablation lesions.

BACKGROUND

Both intrinsic contrast (T₁ and T₂ relaxation and the equilibrium magnetization) and contrast agent (gadolinium)-enhanced MRI are used to visualize and evaluate acute radiofrequency ablation lesions. However, current methods are imprecise in delineating lesion extent shortly after the ablation.

METHODS AND RESULTS

Fifteen lesions were created in the endocardium of 13 pigs. A multicontrast inversion recovery steady state free precession imaging method was used to delineate the acute ablation lesions, exploiting T₁-weighted contrast. T₂ and Mo(*) maps were also created from fast spin echo data in a subset of pigs (n=5) to help characterize the change in intrinsic contrast in the lesions. Gross pathology was used as reference for the lesion size comparison, and the lesion structures were confirmed with histological data. In addition, a colorimetric iron assay was used to measure ferric and ferrous iron content in the lesions and the healthy myocardium in a subset of pigs (n=2). The lesion sizes measured in inversion recovery steady state free precession images were highly correlated with the extent of lesion core identified in gross pathology. Magnetic resonance relaxometry showed that the radiofrequency ablation procedure changes the intrinsic T₁ value in the lesion core and the intrinsic T₂ in the edematous region. Furthermore, the T₁ shortening appeared to be correlated with the presence of ferric iron, which may have been associated with metmyoglobin and methemoglobin in the lesions.

CONCLUSIONS

The study suggests that T₁ contrast may be able to separate necrotic cores from the surrounding edematous rims in acute radiofrequency ablation lesions.