Carsten Meyer MD, Presenter: Nothing to Disclose

Jürgen Haase, Abstract Co-Author: Nothing to Disclose

Beate Büttner, Abstract Co-Author: Nothing to Disclose

Katharina Strach MD, Abstract Co-Author: Nothing to Disclose

Hans Heinz Schild MD, Abstract Co-Author: Nothing to Disclose

Torsten Sommer MD, Abstract Co-Author: Nothing to Disclose

To determine 1) the sensitivity of delayed enhancement (DE) MRI for the detection of acute myocardial infarctions (MI) in patients with biochemically and angiographically confirmed MI after rescue percutaneous coronary intervention (PCI) and 2) the correlation between infarct size as assessed by DE MRI and a) biochemical markers of MI such as creatine-kinase (CK) and c-reactive protein (CRP) as well as b) the time from onset of symptoms to PCI.

45 patients (pts) with MI underwent rescue PCI within 24 hours after onset of symptoms. During a three day follow-up blood levels of CK and CRP were measured every 8 hours. MRI was performed 4 to 10 days after PCI using k-space segmented 3D-IR gradient-echo MR sequences at a 1.5 Tesla system with complete coverage of the left ventricle (in-plane resolution 1.33x1.33 mm2, slice thickness 5 mm, 0,2 mmol/kg GDTPA). The mass of infarcted tissue was calculated and expressed in absolute (g) numbers as well as in relative values in relationship to the total mass of LV myocardium (LV%). Linear regression analysis was performed to assess the correlation between absolute size of infarctions (g) as well as relative size (LV%) with peak values of CK, CRP and the time from onset of symptoms to PCI.

In all pts (n=45/45) acute MI was detected with the technique of DE. The mass of infarcted tissue varied between 1.30 g – 78.8 g, mean 24.2 +/- 17.8. Significant correlation existed between the absolute size of infarctions (g) and peak CK values (r=0.72; p<0.001) as well as the relative size (LV%) and peak CK (r=0.77; p<0.001). No correlations were found between absolute size (r=0.33) as well as relative size (r=0.27) of infarctions and peak CRP. There was also no correlation between absolute (r=0.29) as well as relative size of infarctions (r=0.27) and the time from onset of symptoms to PCI.

1) DE MRI is as sensitive as established biochemical markers for the detection of acute MI. 2) In pts with acute MI (<24h) undergoing rescue PCI, peak CK values correlate well with infarct size as assessed by delayed contrast enhanced MRI. 3) There is no correlation between infarct size and peak CRP as well as the time from onset of symptoms to PCI.

Meyer, C, Haase, J, Büttner, B, Strach, K, Schild, H, Sommer, T, Delayed Contrast-enhanced MRI in Patients with Acute Myocardial Infarction and Percutaneous Coronary Intervention.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4410716.html