Dual inversion recovery late gadolinium enhancement for more accurate infarct size determination: a histological validation study
© Grøndal et al; licensee BioMed Central Ltd. 2013
Published: 30 January 2013
Cardiovascular magnetic resonance (CMR) deploying late gadolinium-enhanced inversion-recovery (IR) sequence is today's standard reference for myocardial infarction evaluation. However, the conventional IR sequence can yield poor image contrast between infarct and intracavity blood pool which complicates precise endocardial border delineation. This compromises accurate infarct size determination and small subendocardial infarct detection. Peel et al. 2012 found that a dual IR prepulse outperformed conventional IR in infarct visualization, scar-to-blood contrast and expert consistency, but this novel technique has not been histopathologically validated. This study sought to compare dual IR prepulse and conventional IR sequences with histopathological findings in an animal model of reperfused acute myocardial infarction.
Under general anaesthesia, ischaemia-reperfusion injury was induced in nine pigs (40 kg) by 40-minute balloon occlusion in LAD followed by reperfusion. One day post-injury, CMR was performed using conventional IR and dual IR sequences at 1.5T. After this, the pigs were euthanized. Their hearts were then explanted, axially cut and incubated in a 2,3,5-triphenyltetrazolium chloride (TTC) solution (10%). CMR images were matched to the corresponding histopathology and the infarct sizes were compared.
In this preliminary, experimental study, the dual IR prepulse resulted in more accurate myocardial infarct size determination compared with conventional IR sequence owing to better blood suppression.
King's College London.
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