Peshock R M, Malloy C R, Buja L M, Nunnally R L, Parkey R W, Willerson J T
Circulation. 1986 Dec;74(6):1434-40. doi: 10.1161/01.cir.74.6.1434.
We examined the effects of a paramagnetic contrast agent, gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) on magnetic resonance images of acute myocardial infarction with and without reperfusion. Twenty-two dogs underwent occlusion of the left anterior descending coronary artery (LAD). In 10 dogs (group I) the LAD remained occluded for 3 hr and in the other 12 (group II) for 2 hr followed by 1 hr of reperfusion. Gd-DTPA (0.34 mM/kg) was administered to five dogs in group I at 2 hr and 5 min after occlusion and to seven dogs in group II 5 min after reperfusion. At 3 hr after ligation, the hearts were excised and imaged with spin echo and inversion recovery pulse sequences on a 0.35 Tesla magnetic resonance imager. Reperfused hearts given Gd-DTPA demonstrated a significant increase in contrast between normal and reperfused myocardium as compared with nonreperfused hearts and reperfused hearts not given Gd-DTPA. This enhancement was particularly prominent in the inversion recovery images. Studies performed in vivo in two additional dogs demonstrated similar enhancement with reperfusion with Gd-DTPA in gated spin echo images. Contrast-enhanced magnetic resonance imaging allows the detection of reperfusion early in the course of acute infarction.
我们研究了一种顺磁性造影剂钆二乙烯三胺五乙酸（Gd-DTPA）对急性心肌梗死再灌注和未再灌注磁共振成像的影响。22只狗接受了左冠状动脉前降支（LAD）闭塞手术。10只狗（I组）LAD持续闭塞3小时，另外12只狗（II组）持续闭塞2小时，随后再灌注1小时。I组5只狗在闭塞后2小时5分钟给予Gd-DTPA（0.34 mM/kg），II组7只狗在再灌注后5分钟给予Gd-DTPA。结扎后3小时，取出心脏，在0.35特斯拉磁共振成像仪上用自旋回波和反转恢复脉冲序列进行成像。与未再灌注心脏和未给予Gd-DTPA的再灌注心脏相比，给予Gd-DTPA的再灌注心脏正常心肌和再灌注心肌之间的对比度显著增加。这种增强在反转恢复图像中尤为明显。在另外两只狗身上进行的体内研究表明，在门控自旋回波图像中，Gd-DTPA再灌注也有类似的增强。对比增强磁共振成像能够在急性梗死早期检测到再灌注。
