Contrast enhanced MRI and MR coronary angiography (MRCA) as one stop shop in patients with untreated myocardial infarction
Journal of Cardiovascular Magnetic Resonance volume 11, Article number: P280 (2009)
To define MRI role in patients with myocardial infarction not treated by PCI.
Methods and materials
24 pts (17 males, 7 females) with myocardial infarction (7 anterior, 9 lateral, 8 inferior), untreated by PCI, underwent MRI within three weeks after infarction. MRI was performed on a 1.5 T scanner (GE Signa Excite) with this protocol:
1) Triple-IR FSE sequence short axis for edema;
2) Fiesta sequences on short, horizontal and vertical long axes, for regional and global systolic function;
3) FGR-ET short axis sequence for first pass;
4) IR-FGRE sequence on short, horizontal and vertical long axes, for infarct size.
5) Before delayed imaging, MRCA with breath-hold 3D Fiesta VCATS technique was obtained. MRCA was compared with the gold standard conventional coronary angiography (CA), performed within 24–48 h.
MRCA was scored with a 3 points scale (0 = good, 1 = sufficient, 2 = poor) by 2 blinded readers; 3 exams were excluded as pts could not hold their breath. MRCA showed 11 severe stenoses (>50%) and 9 occlusions, with 1 exam not evaluable for poor quality; CA showed severe stenoses in 14 and 7 occlusions. Collaterals and retrograde filling were present in 2 occlusions at CA; in these 2 cases DE at MRI was ≤50%. DE and FP defects distribution always showed correlation with the diseased vessel. MRCA showed 100% sensitivity, 78.6% specificity, 70% PPV, 100% NPV.
In pts not treated by primary or rescue PCI, MRCA can rule out occlusion and/or significant stenosis; the correlation with segmental distribution of DE is excellent.
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Liguori, C., Natale, L., Meduri, A. et al. Contrast enhanced MRI and MR coronary angiography (MRCA) as one stop shop in patients with untreated myocardial infarction. J Cardiovasc Magn Reson 11 (Suppl 1), P280 (2009). https://doi.org/10.1186/1532-429X-11-S1-P280