Cardiac MRI to Investigate Myocardial Scar and Coronary Venous Anatomy Using a Slow Infusion of Dimeglumine Gadobenate in Patients Undergoing Assessment for Cardiac Resynchronization Therapy

TY - JOUR

T1 - Cardiac MRI to Investigate Myocardial Scar and Coronary Venous Anatomy Using a Slow Infusion of Dimeglumine Gadobenate in Patients Undergoing Assessment for Cardiac Resynchronization Therapy

AU - Duckett, Simon G.

AU - Chiribiri, Amedeo

AU - Ginks, Matthew

AU - Sinclair, Stephen

AU - Knowles, Benjamin R.

AU - Botnar, Rene

AU - Carr-White, Gerald

AU - Rinaldi, Christopher Aldo

AU - Nagel, Eike

AU - Razavi, Reza

AU - Schaeffter, Tobias

PY - 2011/1

Y1 - 2011/1

N2 - Purpose: To evaluate a cardiac MR (CMR) examination with slow infusion of a high-relaxivity contrast agent to visualize coronary venous anatomy (CVA) and myocardial scar in heart failure patients awaiting cardiac resynchronization therapy (CRT).Materials and Methods: Fourteen patients awaiting CRT (seven ischemic cardiomyopathy (ICM) and seven non-ICM) and two with normal LV function underwent CMR on a 1.5 Tesla (T) MR scanner. Dimeglumine-gadobenate was slowly infused. Bolus arrival in the LV was measured by a dynamic electrocardiogram (ECG) -triggered inversion recovery (IR) scan subsequent to starting an ECG-triggered respiratory-navigated three-dimensional (3D) SSFP MR scan with IR preparation to acquire systolic whole-heart anatomy for vein visualization. Delayed contrast-enhanced MR scan was performed to assess myocardial scar. CVA obtained by CMR was compared with Xray venography in 11 patients. CVA and scar were segmented and registered for visual inspection.Results: For all subjects, there was excellent visualization of the CVA. All ICM and one non-ICM patient showed scar. There was excellent correlation between veins seen by CMR and venography.Conclusion: We have demonstrated that slow infusion protocol of dimeglumine-gadobenate can be used to assess both CVA and myocardial scar in a single MR examination. Furthermore, an image overlay technique has been used to show the relationship of scar to the CVA.

AB - Purpose: To evaluate a cardiac MR (CMR) examination with slow infusion of a high-relaxivity contrast agent to visualize coronary venous anatomy (CVA) and myocardial scar in heart failure patients awaiting cardiac resynchronization therapy (CRT).Materials and Methods: Fourteen patients awaiting CRT (seven ischemic cardiomyopathy (ICM) and seven non-ICM) and two with normal LV function underwent CMR on a 1.5 Tesla (T) MR scanner. Dimeglumine-gadobenate was slowly infused. Bolus arrival in the LV was measured by a dynamic electrocardiogram (ECG) -triggered inversion recovery (IR) scan subsequent to starting an ECG-triggered respiratory-navigated three-dimensional (3D) SSFP MR scan with IR preparation to acquire systolic whole-heart anatomy for vein visualization. Delayed contrast-enhanced MR scan was performed to assess myocardial scar. CVA obtained by CMR was compared with Xray venography in 11 patients. CVA and scar were segmented and registered for visual inspection.Results: For all subjects, there was excellent visualization of the CVA. All ICM and one non-ICM patient showed scar. There was excellent correlation between veins seen by CMR and venography.Conclusion: We have demonstrated that slow infusion protocol of dimeglumine-gadobenate can be used to assess both CVA and myocardial scar in a single MR examination. Furthermore, an image overlay technique has been used to show the relationship of scar to the CVA.

U2 - 10.1002/jmri.22387

DO - 10.1002/jmri.22387

M3 - Article

VL - 33

SP - 87

EP - 95

JO - Journal of Magnetic Resonance Imaging

JF - Journal of Magnetic Resonance Imaging

IS - 1

ER -