Chronic myocardial infarction: Assessment of morphology, function, and perfusion by gradient echo magnetic resonance imaging and 99mTc-methoxyisobutyl-isonitrile SPECT

doi:10.1016/0002-8703(92)90501-L

American Heart Journal

Volume 123, Issue 3, March 1992, Pages 636-645

https://doi.org/10.1016/0002-8703(92)90501-L Get rights and content

Abstract

To assess the ability of magnetic resonance imaging (MRI) to identify the anatomic and functional abnormalities associated with completely scarred myocardium, 20 patients with chronic transmural myocardial infarction confirmed by electrocardiography and cineventriculography were examined by gradient echo MRI. Myocardial perfusion at rest was assessed in corresponding transverse sections using ^99mTc-methoxyisobutyl-isonitrile single-photon emission computed tomography (MIBI-SPECT). MRI scar was defined as diastolic wall thickness (DWT) 2.5 SD below corresponding normal values or systolic wall thickening (ΔWT) ≤ 1 mm. For MIBI-SPECT images, scar was defined as a MIBI uptake < 2.5 SD below normal values. By MIBI-SPECT, 152 segments contained normal tissue and 88 contained scarred myocardium. In 226 of 240 (94%) segments, MRI gradings by DWT and MIBI-SPECT gradings were identical. DWT by MRI was higher in normal than in scarred MIBI-SPECT segments (10 ± 1 versus 4 ± 2 mm, p < 0.001). In 230 of 240 (96%) segments, MRI gradings by ΔWT and MIBI-SPECT gradings were identical. Segments graded normal by MIBI-SPECT showed higher ΔWT by MRI than scar segments (5 ± 1 versus 0.3 ± 1 mm, p < 0.001). MIBI-SPECT perfusion defect size and regions with reduced DWT on MRI tomograms correlated well (r = 0.85). This study indicates that myocardial regions fulfilling electrocardiographic and ventriculographic criteria for transmural myocardial scar are clearly depicted by regional diastolic wall thinning and ΔWT ≤ 1 mm on gradient echo MR images. Therefore this technique may be used to confirm the presence of myocardial scar in patients with perfusion defects seen on MIBI-SPECT images.

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Chronic myocardial infarction: Assessment of morphology, function, and perfusion by gradient echo magnetic resonance imaging and 99mTc-methoxyisobutyl-isonitrile SPECT

Abstract

J Am Coll Cardiol

J Am Coll Cardiol

Chest

Am Heart J

Am J Cardiol

Am J Cardiol

Am J Cardiol

Am Heart J

J Am Coll Cardiol

J Am Coll Cardiol

Am J Cardiol

Am J Cardiol

J Am Coll Cardiol

J Am Coll Cardiol

J Am Coll Cardiol

J Am Coll Cardiol

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N Engl J Med

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Circulation

A new Tc-99m-labeled myocardial imaging agent, hexakis (t-butylisonitrile)-technetium (Tc-99m TBI): initial experience in humans

J Nucl Med

Comparative study of two independant observers of the uptake abnormalities of 201Tl and Tc-99m-MIBI in 81 patients with coronary artery disease [Abstract]

J Nucl Med

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J Nucl Med

Chronic myocardial infarction: Assessment of morphology, function, and perfusion by gradient echo magnetic resonance imaging and ^99mTc-methoxyisobutyl-isonitrile SPECT