Circulation. 2002;105:224-229
doi: 10.1161/hc0202.102016
doi: 10.1161/hc0202.102016
(Circulation. 2002;105:224.)
© 2002 American Heart Association, Inc.
Basic Science Reports |
Myocardial Magnetic Resonance Imaging Contrast Agent Concentrations After Reversible and Irreversible Ischemic Injury
From the Northwestern University Medical School Feinberg Cardiovascular Research Institute (W.G.R., D.S.F., E.-L.C., R.J.K., R.M.J.), Departments of Medicine (R.J.K., R.M.J.) and Biomedical Engineering (W.G.R., D.S.F., R.M.J.), Chicago, Ill.
Correspondence to Robert M. Judd, PhD, Codirector, Duke Cardiovascular Magnetic Resonance Center, Duke University Medical Center, PO Box 3934, Durham, NC 27710. E-mail Robert.Judd{at}dcrmc.mc.duke.edu
Background— Discrepant reports have been published recently regarding the relationship of contrast-enhanced magnetic resonance image intensities to reversible and irreversible ischemic injury. Unlike image intensities, contrast agent concentrations provide data independent of the MRI technique. We used electron probe x-ray microanalysis (EPXMA) to simultaneously examine concentrations of Gd, Na, P, S, Cl, K, and Ca over a range of myocardial injuries.
Methods and Results— Reversible and irreversible injury were studied in 38 rabbits divided into 4 groups defined by occlusion and reperfusion time, as well as time the animals were euthanized. Gd-DTPA was administered, and the hearts were excised and rapidly frozen, cryosectioned, freeze-dried, and examined by EPXMA in up to 3 regions: remote, infarcted, and at risk but not infarcted. Infarcted regions were defined by anti-myoglobin antibody or triphenyltetrazolium chloride staining. Regions at risk were defined by fluorescent microparticles administered during occlusion. Compared with remote regions, in acutely infarcted regions, Gd was increased (235±24%, P<0.005) in the same 50x100-µm areas in which Na was increased (154±5%, P<0.001) and K was decreased (52±8%, P<0.001). Similarly, in chronically infarcted regions, Gd was increased (472±78%, P<0.001) in areas in which Na was increased (332±28%, P<0.001) and K was decreased (47±5%, P<0.001). Also compared with remote regions, however, concentrations of Gd, Na, and K were not elevated after reperfusion in regions that were at risk but not infarcted (P=NS).
Conclusions— Regional elevations in myocardial MRI contrast agent concentrations are exclusively associated with irreversible ischemic injury defined histologically and by regional electrolyte concentrations.
Key Words: magnetic resonance imaging • contrast media • infarction • ischemia
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