Karl Friedrich Kreitner MD, Presenter: Nothing to Disclose

Nico Abegunewardene, Abstract Co-Author: Nothing to Disclose

Peter Kunz, Abstract Co-Author: Nothing to Disclose

Markus Vosseler, Abstract Co-Author: Nothing to Disclose

Katja Oberholzer MD, Abstract Co-Author: Nothing to Disclose

Katja Koch MD, Abstract Co-Author: Nothing to Disclose

Georg Horstick, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Cardiovascular MR imaging (CMR) with assessment of late enhancement (LE) and no-reflow zones (MO) enables prognostic implications for further patient care. In a prospective study, LE and MO were evaluated in patients with acute amyocardial infarctions (AMI) and successful recanalization (acute stent-PTCA) with a 1-year follow-up.

Group 1 consisted of 35 patients (mean age: 55 years) with acute AMI and two CMR examinations within 10 days, the first within 48 hours after AMI. Group 2 consisted of 37 patients (mean age: 56 years) that were examined once within 10 days after AMI. Further follow-up studies were performed after 6 and 12 months. CMR was performed at 1.5 T (Magnetom Sonata Ò, Siemens Medical Systems) using a phased array coil for signal detection. For assessment of LE and MO, we used and inversion prepared 2D and 3D segmented TurboFlash sequence after determination of optimal TI in short-axis orientation of the heart. LE and MO were measured 2 and 10 minutes after application of 0.2 mmol Gd-DTPA /kg body weight. The left ventricle was further assessed planimetrically.

Areas of LE significantly decreased in patients of group 1 within 10 days between the first and second CMR examination from 20.4 +/- 12.1 % to 16.9 +/- 10.5 % (p < 0.05), and areas of MO from 3.4 to 2.4 % (p < 0.05). Areas of MO were detected in 24 patients of group 2. The number of patients with MO decreased to ten after 6, and to two after 12 months. The extent of MO was largest on images obtained 2 minutes after contrast agent application, and it signifivantly decreased in size ten minutes after contrast application.

The real extent of MO is best assessed on images obtained 2 minutes after contrast application and within 24-48 hours after acute MI. The areas of LE decreased from the acute to the subacute phase after AMI, in some patients this could be demonstrated even after 1 year. For assessment of prognostic parameters after AMI with successful recanalization, CMR imaging should be performed within 48 hours after AMI.

Kreitner, K, Abegunewardene, N, Kunz, P, Vosseler, M, Oberholzer, K, Koch, K, Horstick, G, et al, , One-year Follow-up of Patients with Acute Myocardial Infarctions and Acute Recanalization: Assessment of Areas of No-reflow Zones and Late Enhancement.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4416247.html