Delayed enhancement after injection of Gd-DTPA in dysfunctional myocardiumcorrelation with regional wall motion improvement after revascularization

Purpose: The aim of the study was to correlate delayed contrast enhancement of dysfunctional regions of the myocardium after injection of Gd-DTPA with the improvement of regional contractility 3 months after revascularization . Material and methods: Eleven patients with coronary artery disease and wall motion abnormalities underwent MR imaging before and 3 months after revasc ularization therapy (PTCA or CABG). Short-axis images were acquired using a cine gradient echo sequence. After revascularization, a representative sli ce was analyzed 14+/-1 min after injection of 0.1 mmol/kg Gd-DTPA using a T 1-weighted turbo fast low-angle shot sequence. Improved systolic wall thick ening 3 months after revascularization served as criterion of viability and was correlated with delayed contrast enhancement patterns. Results: After revascularization, 6 patients showed complete recovery of th e dysfunctional area, 1 patient partial recovery,and 4 patients remained un changed. All 4 patients with persisting wall motion abnormalities, 1/6 pati ents with recovery and the patient with partial recovery revealed a delayed enhancement Conclusions: Three months after revascularization, delayed enhancement of d ysfunctional myocardium is evident in patients without regional wall motion improvement, while the lack of delayed enhancement correlates with improve ment of regional contractility.