Differential MR delayed enhancement patterns of chronic myocardial infarction between extracellular and intravascular contrast media

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DOIResolve DOI: http://doi.org/10.1371/journal.pone.0121326
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TypeArticle
Journal titlePLoS ONE
ISSN1932-6203
Volume10
Issue3
Article numbere0121326
Subjectcollagen; dye; eosin; gadolinium pentetate meglumine; gadomelitol; hematoxylin; Masson trichrome stain; animal experiment; animal model; animal tissue; chronic heart infarction; cineradiography; collagen fiber; contrast enhancement; controlled study; coronary artery occlusion; heart hypertrophy; heart infarction; heart muscle blood flow; heart muscle cell; heart muscle perfusion; heart ventricle remodeling; histopathology; image analysis; nonhuman; nuclear magnetic resonance imaging; nuclear magnetic resonance scanner; scar; signal processing; swine; vasodilatation; Suidae
AbstractObjectives: Because the distribution volume and mechanism of extracellular and intravascular MR contrast media differ considerably, the enhancement pattern of chronic myocardial infarction with extracellular or intravascular media might also be different. This study aims to investigate the differences in MR enhancement patterns of chronic myocardial infarction between extracellular and intravascular contrast media. Materials and Methods: Twenty pigs with myocardial infarction underwent cine MRI, first pass perfusion MRI and delayed enhancement MRI with extracellular or intravascular media at four weeks after coronary occlusion. Myocardial blood flow (MBF) was determined with microsphere measurement. The infarction histopathological changes were evaluated by hematoxylin and eosin staining and Masson's trichrome method. Results: Cine MRI revealed the reduced wall thickening in chronic infarction compared with normal myocardium. Moreover, significant wall thinning in chronic infarction was observed in cine MRI. Peak first-pass signal intensity didn' t significantly differ between chronic infarction and normal myocardium no matter what kinds of contrast media. At the following delayed enhancement phase, extracellular media-enhanced signal intensity was significantly higher in chronic infarction than in normal myocardium. Conversely, intravascular media-enhanced signal intensity was almost equivalent among chronic infarction and normal myocardium. At four weeks after infarction, MBF in chronic infarction approached to that in normal myocardium. Large thick-walled vessels were detected at peri-infarction zones. The cardiomyocytes were replaced by scar tissue consisting of dilated blood vessels and discrete fibers of collagen. Conclusions: Chronic infarction was characterized by the significantly reduced wall thickening and the definite wall thinning. First-pass myocardial perfusion defect was not detected in chronic infarction with two media due to the significantly recovered MBF and well-developed collateral vessels. Infarction remodeling enlarged the extracellular compartment, which was available for extracellular media but not accessible to intravascular media. Extracellular media identified chronic infarction as the hyper-enhancement; nonetheless, intravascular media didn't provide delayed enhancement.
Publication date
PublisherPLOS
LanguageEnglish
AffiliationNational Research Council Canada; NRC Institute for Biodiagnostics; Medical Devices
Peer reviewedYes
NPARC number21275706
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Record identifier426c547b-fa29-47a8-ac7e-7f0185e13567
Record created2015-07-14
Record modified2016-05-09
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