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PURPOSE: The aim of the study was to correlate delayed contrast enhancement of dysfunctional regions of the myocardium after injection of Gd-DTPA with the improvement of regional contractility 3 months after revascularization. MATERIAL AND METHODS: Eleven patients with coronary artery disease and wall motion abnormalities underwent MR imaging before and 3 months after revascularization therapy (PTCA or CABG). Short-axis images were acquired using a cine gradient echo sequence. After revascularization, a representative slice was analyzed 14 +/- 1 min after injection of 0.1 mmol/kg Gd-DTPA using a T1-weighted turbo fast low-angle shot sequence. Improved systolic wall thickening 3 months after revascularization served as criterion of viability and was correlated with delayed contrast enhancement patterns. RESULTS: After revascularization, 6 patients showed complete recovery of the dysfunctional area, 1 patient partial recovery, and 4 patients remained unchanged. All 4 patients with persisting wall motion abnormalities, 1/6 patients with recovery and the patient with partial recovery revealed a delayed enhancement. CONCLUSIONS: Three months after revascularization, delayed enhancement of dysfunctional myocardium is evident in patients without regional wall motion improvement, while the lack of delayed enhancement correlates with improvement of regional contractility.

Type

Journal article

Journal

Radiologe

Publication Date

02/2000

Volume

40

Pages

150 - 154

Keywords

Adult, Aged, Contrast Media, Diastole, Female, Follow-Up Studies, Gadolinium DTPA, Humans, Image Enhancement, Magnetic Resonance Imaging, Male, Middle Aged, Myocardial Contraction, Myocardial Infarction, Myocardial Revascularization, Myocardial Stunning, Sensitivity and Specificity, Systole, Treatment Outcome, Ventricular Dysfunction, Left