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Detection of myocardial infarctions by acquisition‐weighted 31 P‐MR spectroscopy in humans
Author(s) -
Beer Meinrad,
Spindler Matthias,
Sandstede Joern J.W.,
Remmert Haiko,
Beer Stephanie,
Köstler Herbert,
Hahn Dietbert
Publication year - 2004
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.20185
Subject(s) - phosphocreatine , medicine , myocardial infarction , ejection fraction , nuclear medicine , magnetic resonance imaging , cardiology , in vivo magnetic resonance spectroscopy , asynergy , radiology , energy metabolism , heart failure , radionuclide ventriculography
Purpose To determine whether the recently applied technique of acquisition‐weighted 31 P‐MR spectroscopy (AW‐MRS) allows for the detection of depressed energy metabolism in patients with inferior wall myocardial infarctions. Materials and Methods Eight patients with subacute myocardial infarction and wall motion abnormalities restricted to the inferior wall were examined with a 1.5‐T MR scanner. Global and regional left ventricular (LV) function was assessed by cine MRI, and the size and extent of myocardial infarction was assessed by late enhancement (LE). MRS was performed with an AW three‐dimensional chemical shift imaging sequence. Phosphocreatine/ATP ratios were determined with the postprocessing model AMARES for four voxels positioned in the anterior, lateral, inferior, and septal parts of the LV. Results The LV ejection fraction (EF) was reduced to 37.5% ± 9.0%. Seven of eight patients had transmural LE in the inferior wall, and one patient showed subendocardial enhancement in the inferior‐lateral parts. Phosphocreatine/ATP ratios of the inferior wall were significantly reduced ( P < 0.05) compared to all other parts of the LV (1.03 ± 0.39 (inferior), 1.67 ± 0.81 (lateral), 1.73 ± 0.29 (anterior), and 1.49 ± 0.31 (septal)). The ratios in five of seven patients with transmural enhancement were <1.00 in the inferior wall. Conclusion Acquisition weighting allows for the detection of inferior wall infarctions in patients. Transmural signal enhancement is associated with significant depression of phosphocreatine/ATP ratios. J. Magn. Reson. Imaging 2004;20:798–802. © 2004 Wiley‐Liss, Inc.