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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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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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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
- Coronary Angiography
- Short Axis
- Conventional Coronary Angiography
- Signa Excite
- Blinded Reader