ASSESSMENT OF ACUTE MYOCARDIAL-INFARCTION IN MAN WITH MAGNETIC-RESONANCE-IMAGING AND THE USE OF A NEW PARAMAGNETIC CONTRAST AGENT GADOLINIUM-BOPTA

To assess the feasibility of and characterize the new paramagnetic con trast agent gadolinium-BOPTA/dimeglumine (Gd-BOPTA) to detect acute my ocardial infarctions with MR imaging, 24 patients (53.3 +/- 8.3 yr) we re examined 9.3 +/- 3.6 days after a first myocardial infarction. Shor t-axis T-1-weighted and T-2-weighted MR imaging was performed at three slice levels. T-1-weighted images were obtained before, immediately a fter, 15, 30, and 45 min after injection, Patients received either 0.0 5 or 0.1 mmol/kg body weight Gd-BOPTA, Images were qualitatively and q uantitatively analyzed. Two patients showed no signs of infarction on T-2-weighted images as opposed to contrast-enhanced T-1-weighted image s, Contrast-to-noise ratio was not affected by the dosage level, Signa l intensity (SI) of normal to infarcted myocardium was significantly i mproved by both dosages (p < .0005) but a dosage of 0.05 mmol/kg produ ced significantly higher SI inf/norm (1.42 +/- 0.07 vs, 1.34 +/- 0.06, respectively, p = .015), SI of normal and infarcted myocardium enhanc ed immediately after administration of 0.05 mmol/kg (29.3 +/- 5.1% and 53.8 +/- 9.6% respectively), which decreased thereafter to 5.3 +/- 4. 8% and 40.2 +/- 8.5% respectively, at 45 min(p < .002 for normal myoca rdium). SI enhancement immediately after 0.1 mmol/kg Gd-BOPTA showed n o decrease within the first 45 min, Gd-BOPTA enables the detection of myocardial infarction, Optimal infarct delineation is achieved from 15 to 45 min after administration of 0.05 mmol/kg body weight Gd-BOPTA, Gd-BOPTA at 0.05 mmol/kg does improve image quality as measured by con trast-to-noise ratio and SI enhancement as compared to 0.10 mmol/kg.