DETECTION OF RIGHT-VENTRICULAR INFARCTION BY GADOLINIUM DTPA-ENHANCEDMAGNETIC-RESONANCE-IMAGING

We investigated the usefulness of gadolinium-enhanced magnetic resonan ce (Gd-MR) imaging for diagnosis of right ventricular (RV) infarction in 14 patients with acute inferior infarction. Myocardial perfusion im ages with thallium 201 and technetium 99m pyrophosphate (dual single-p hoton emission computed tomography: dual SPECT) and haemodynamic data were obtained on admission. Patients were classified into three groups based on dual SPECT and Gd-MR findings: no accumulation in the right ventricle (negative, Type I), posterior RV infarction (Type 2) and ant erior and posterior RV infarction (Type 3). No patients exhibited the haemodynamic criteria for RV infarction (a mean light atrial pressure above 10 mmHg and a ratio of mean right atrial pressure to pulmonary a rtery wedge pressure above 0.8). Dual SPECT identified RV infarction i n eight patients (three Type 2 and five Type 3, 57% of the total). Gd- MR imaging also identified eight patients (57%) as positive (five Type 2 and three Type 3). Our results showed that Gd-MR imaging was not on ly useful for diagnosis of RV infarction, but also equal to dual SPECT in sensitivity and specificity, and superior to it as regards acquisi tion time and assessing the spatial anatomy of heart. In conclusion, G d-MR imaging is superior to dual SPECT for detection of RV infarction.