(Circulation. 2000;102:698.)
© 2000 American Heart Association, Inc.
Basic Science Reports |
Visualization and Temporal/Spatial Characterization of Cardiac Radiofrequency Ablation Lesions Using Magnetic Resonance Imaging
From the Departments of Radiology (A.C.L., E.R.M.), Medicine (A.C.L., P.J., R.D.B., H.C., J.L., H.R.H.), Biomedical Engineering (A.C.L., E.R.M., H.R.H.), and Surgery (A.C.L.), Johns Hopkins University School of Medicine, Baltimore, Md.
Correspondence to Albert C. Lardo, PhD, Johns Hopkins School of Medicine, 601 N Caroline St, 4242 JHOC, Baltimore, MD 21287. E-mail alardo{at}mri.jhu.edu
Background—The purpose of this study was to describe a system and method for creating, visualizing, and monitoring cardiac radiofrequency ablation (RFA) therapy during magnetic resonance imaging (MRI).
Methods and Results—RFA was performed in the right
ventricular apex of 6 healthy mongrel dogs with a custom 7F
nonmagnetic ablation catheter (4-mm electrode) in a newly developed
real-time interactive cardiac MRI system. Catheters were positioned to
intracardiac targets by use of an MRI fluoroscopy sequence, and ablated
tissue was imaged with T2-weighted fast spin-echo and contrast-enhanced
T1-weighted gradient-echo sequences. Lesion size by MRI was determined
and compared with measurements at gross and histopathological
examination. Ablated areas of myocardium appeared as
hyperintense regions directly adjacent to the catheter tip and could be
detected 2 minutes after RF delivery. Lesions reached maximum size 
5
minutes after ablation, whereas lesion signal intensity increased
linearly with time but then reached a plateau at 12.2±2.1 minutes.
Lesion size by MR correlated well with actual postmortem lesion size
and histological necrosis area (55.4±7.2 versus
49.7±5.9 mm2, r=0.958,
P<0.05).
Conclusions—RFA can be performed in vivo in a new real-time interactive cardiac MRI system. The spatial and temporal extent of cardiac lesions can be visualized and monitored by T2- and T1-weighted imaging, and MRI lesion size agrees well with actual postmortem lesion size. MRI-guided RFA may be a useful approach to help facilitate anatomic lesion placement and to provide insight into the biophysical effects of new ablation techniques and technologies.
Key Words: catheter ablation • magnetic resonance imaging • histopathology • fluoroscopy
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