Cor Vasa 2004, 45(10):497-502
Magnetic resonance in detecting the viable myocardium
- 1 I. interní klinika
- 2 Radiologická klinika, Fakultní nemocnice Hradec Králové, Hradec Králové
- 3 Základna radiodiagnostiky a intervenční radiologie, Institut klinické a experimentální medicíny, Praha, Česká republika
Determination of myocardial viability is important for identifying the optimal therapeutic procedure in patients with ischemic cardiomyopathy. A new diagnostic method possibly used for detecting a viable myocardium is magnetic resonance (MR). Using MR, a viable myocardium can be visualized with the help of several methods. Exercise dynamic MR is an analogy of exercise echocardiography. Other procedures are based on visualizing the different various structures of viable versus nonviable myocardium. Irreversible myocardial injury sustained during acute myocardial injury is characterized by an increased intensity of T2 weighted signal. The largest body of clinical experience has been gained with post-contrast MR imaging. The uptake of the paramagnetic gadolinium-containing contrast medium is significantly higher in areas of acute and chronic myocardial infarction. Accumulation of the paramagnetic contrast medium during an MR study is consistent with the extent of irreversible myocardial injury. The transmural extent of contrast-enhanced tissue suggests a systolic left ventricular improvement post-revascularization. Irreversible myocardial injury, as detected by positron emission tomography, and considered the gold standard for myocardial viability detection by some authors, is consistent with the appreciable contrast medium accumulation during MR imaging. Post-contrast MR imaging may thus serve as an alternative to other methods of examination used to identify a viable myocardium.
Keywords: Magnetic resonance; Myocardial viability; Ischemic cardiomyopathy
Published: October 1, 2004 Show citation