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Characterization of the peri-infarction zone using T2-weighted MRI and delayed-enhancement MRI in patients with acute myocardial infarction

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Abstract

To characterize the peri-infarction zone using T2-weighted (T2w) magnetic resonance imaging (MRI) and infarct size on delayed enhancement (DE) MRI in patients with acute myocardial infarction (AMI). In 65 patients, short-axis T2w and DE MRI images were acquired 5 ± 3 d after AMI. The MRI was analyzed using a threshold method defining infarct size on DE MRI and edema on T2w MRI as areas with signal intensity larger than +2 SD above remote normal myocardium. The peri-infarction zone was calculated as the difference between the size of edema and the infarct size. The size of edema on T2w MRI (31.3 ± 13.4% of LV area) was larger than the infarct size on DE MRI (20.3 ± 10.4% of LV area, p< 0.0001). The size of the peri-infarction zone was 11.0 ± 10.0% of the LV area. Good correlation was found between infarct size on DE MRI and peak creatine kinase (CK) isoenzyme MB (r = 0.65, p< 0.0001), but there was no correlation between the size of the peri-infarction zone and CK MB (r = 0.05, p = 0.67). The peri-infarction zone was larger in patients with an infarct size <28% of the LV area (12.6 ± 10.0% LV area) compared with patients with an infarct size ≥28% of the LV area (6.7 ± 9.0% of the LV area, p< 0.05). The peri-infarction zone does not correlate with enzymatic parameters of infarct size and is substantially larger in small infarcts, indicating viable myocardium.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

    Alexander Stork, Paul M. Bansmann, Claus Nolte-Ernsting, Joern Kemper, Philipp G. C. Begemann & Gerhard Adam

  2. Department of Cardiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

    Gunnar K. Lund & Kai Muellerleile

Authors
  1. Alexander Stork
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  2. Gunnar K. Lund
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  3. Kai Muellerleile
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  4. Paul M. Bansmann
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  5. Claus Nolte-Ernsting
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  6. Joern Kemper
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  7. Philipp G. C. Begemann
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  8. Gerhard Adam
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Correspondence to Alexander Stork.

Additional information

This study was funded in part by Pinguin-Stiftung, Duesseldorf, Germany and by Schering Company, Berlin, Germany.

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Stork, A., Lund, G.K., Muellerleile, K. et al. Characterization of the peri-infarction zone using T2-weighted MRI and delayed-enhancement MRI in patients with acute myocardial infarction. Eur Radiol 16, 2350–2357 (2006). https://doi.org/10.1007/s00330-006-0232-3

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  • DOI: https://doi.org/10.1007/s00330-006-0232-3

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