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Intracoronary delivery of Gd-DTPA and Gadophrin-2 for determination of myocardial viability with MR imaging

Intracoronary delivery of Gd-DTPA and Gadophrin-2 for determination of myocardial viability with MR imaging,10.1007/s003300000791,European Radiology,Y

Intracoronary delivery of Gd-DTPA and Gadophrin-2 for determination of myocardial viability with MR imaging   (Citations: 15)
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The aim of this study was to compare intracoronary (i. c.) administration of Gadophrin-2, a necrosis-avid contrast agent (NACA), and nonspecific agent Gd-DTPA for determination of myocardial viability (MV) in acute myocardial infarction (AMI) with MRI. Reperfused AMI was induced in 12 dogs by transcatheter balloon occlusion of coronary artery. In 6 dogs each, Gd-DTPA at 0.1 mmol/kg or Gadophrin-2 at 0.005 mmol/kg was administered into coronary artery by fast bolus (n = 3) or slow infusion (n = 3). Serial ECG-triggered cardiac MRI of T1-weighted segmented turbo fast low-angle shot (FLASH) sequence was conducted and compared with triphenyltetrazolium chloride (TTC) histochemical staining. The contrast ratio and infarct size were quantified and analysed statistically. No cardiovascular side effects were found with local delivery of both agents. After i. c. administration, Gadophrin-2 induced a strong (CR ≥ 1.78) and persistent ( ≥ 10 h) contrast enhancement of infarcted region. The infarct size defined with Gadophrin-2 was almost identical to that with TTC staining throughout the postcontrast period. With a dose 20 times higher, Gd-DTPA also strongly enhanced infarct-to-normal contrast; however, the enhancement diminished with time, i. e. from early strong to later faint enhancement and eventual loss of contrast. The delineated infarct size was also unstable, i. e. from early overestimation to later underestimation and eventual disappearance of the enhanced infarct. In combination with PTCA procedure, i. c. administration of MRI contrast agents may prove useful for post-procedure verification of diagnosis. The NACA-enhanced MRI may serve as an in vivo surrogate of postmortem histochemical staining for determination of MV. Although applicable in clinical setting, cardiac MRI with nonspecific Gd-DTPA is less reliable and should be performed within less than 1 h after contrast.
Journal: European Radiology - EUROPEAN RADIOL , vol. 11, no. 5, pp. 876-883, 2001
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    • ...This minute dose was found more appropriate after a pilot study in 2 pigs with a dose at 0.005 mmol/kg, similar to that of Gadophrin-2 intracoronarily injected in a previous study [25]...
    • ...The methods for imaging quantification and analysis were adapted from a previously published article [25]...
    • ...By contrast, intracoronary administration of an 80· smaller dose of ECIII-60 induced a strong and persistent contrast enhancement on T1-weighted MRI and the size of the enhanced area remained identical to that of TTC-negatively stained MI over a period of 5 hr, which is supported by previous studies with the porphyrin NACA Gadophrin-2 administered in the same manner [22, 25]...
    • ...It has been reported that when both agents were delivered intracoronarily, Gadophrin-2 at 0.005 mmol/kg outperformed Gd-DTPA at 0.1 mmol/kg for MRI determination of myocardial viability [25]...
    • ...First, both porphyrin and nonporphyrin NACAs share the same necrosis avidity and cause prolonged and accurate labeling of acute MI on MRI [15, 18–33] and similar approach using Gadophrin-2 was reported to be successful in dogs with reperfused acute MI [22, 25]...
    • ...Another advantage of local administration of NACAs is that persistent infarct labeling can be achieved instantaneously [22, 25], whereas it usually takes at least 1– 3 hr after intravenous administration to display an NACAinduced specific contrast effect [18–21, 23, 24, 26–28]...
    • ...In contrast, it was proved to be impractical to combine local Gd-DTPA delivery during PTCA with subsequent cardiac MRI due to inaccurate delineation of the infarct resulting from rapid washout of this nonspecific CA [25]...
    • ...Moreover, diffusion distance and, therefore, duration of DE also depend on lesion size, which justifies the observed faster contrast washout in the smaller infarcts induced in this study relative to the contrast washout in larger infarcts reported previously [25]...

    Jiyang Jinet al. Magnetic Resonance Imaging of Acute Reperfused Myocardial Infarction: ...

    • ...after intravenous administration of ECIV-7 at early phase every10minforthefirsthourandatdelayedphasebetween 6 h and 24 h after contrast enhancement, according to previous experiences with NACAs [11, 12, 16, 24, 25]...

    Yicheng Niet al. Magnetic resonance imaging after radiofrequency ablation in a rodent m...

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