MR-IMAGING OF CARDIAC-FUNCTION AND PERFUS ION IN PATIENTS AFTER MYOCARDIAL-INFARCTION

Purpose: With the advent of fast pulse sequences, MR imaging of myocar dial function and perfusion in ischaemic heart disease has become poss ible. Prior studies examined either myocardial perfusion or systolic w all motion. We intended to establish an examination procedure to simul taneously investigate regional myocardial motility and perfusion in pa tients 7-14 days after myocardial infarction. Methods: A Turbo-FLASH 2 D sequence was optimised to maximise image contrast between normal and malperfused myocardium after Gd-injection using a calculation model b asing on the Bloch equation. Calculated values for trigger delay TD, i nversion time T1 and flip angle alpha were confirmed in a Gd-phantom a nd healthy volunteers. Subsequently, myocardial motility was studied ( cine FLASH 2D sequence) and in slice positions with reduced wall thick ening first pass and post contrast studies after 2-10 minutes were per formed using the optimised Turbo-FLASH sequence. Results: First pass S I-differences of normal compared to malperfused myocardium vary in rel ation to TD, TI and alpha in a relevant degree. Reduced myocardial mot ility was found with a sensitivity of 81% and specificity of 96%. Path ological perfusion patterns were detectable in all of these patients. Conclusions: A combined examination of motility and perfusion is possi ble by means of MRI and information about the status of postinfarct my ocardium can be obtained.