Time course of contrast enhancement patterns after Gd-BOPTA in correlation to myocardial infarction and viability: A feasibility study

Our objective was to analyze contrast enhancement patterns (CEP) and their time course after myocardial infarction (MI) following injection of Gd‐BOPTA in correlation with recovery of regional function. Seven patients with subacute MI (18 ± nine days) were examined before, as well as three and six (n = six) months after, revascularization of the infarct‐related artery. Regional wall motion abnormalities were assessed by cine‐MRI, and repetitive images of one representative slice were acquired up to 45 minutes after 0.05 mmol/kg Gd‐BOPTA using a T1‐w TSE‐sequence. Two patients showed mid‐wall/subendocardial, one patient subendocardial enhancement of MI associated with mechanical improvement after revascularization. Three patients without improvement revealed a mid‐wall hypoenhanced zone within the first five minutes after injection, which was unchanged at follow‐up. One patient with partial functional improvement showed transmural enhancement and a mid‐wall hypoenhanced zone in adjacent areas. With this feasibility study, we concluded that mid‐wall and/or subendocardial enhancement after Gd‐BOPTA was associated with viable myocardium, whereas detection of microvascular obstruction correlating with scar formation is suggested by mid‐wall hypoenhancement within the first five minutes after injection. J. Magn. Reson. Imaging 2001;14:789–794. © 2001 Wiley‐Liss, Inc.