First-pass Myocardial Perfusion Defect and Delayed Contrast Enhancement in Hypertrophic Cardiomyopathy Assessed with MRI

Tsuyoshi MATSUNAKA, Mareomi HAMADA, Yuji MATSUMOTO, Jitsuo HIGAKI
2003 Magnetic Resonance in Medical Sciences  
Gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) enhanced magnetic resonance imaging (MRI) is known to be useful for detecting myocardial injury. In this study, we usedˆrst-pass myocardial perfusion and delayed contrast-enhanced MRI to determine whether an abnormal signal intensity was related to the left ventricular regional contractile function in patients with hypertrophic cardiomyopathy (HCM). Materials and Methods: Twelve patients with HCM participated in this study. Four short
more » ... l cine images of the left ventricle were acquired. Subsequently,ˆrst-pass myocardial perfusion images during theˆrst passage of Gd-DTPA (0.1 mmol W kg), and delayed contrast-enhanced images after a 15-min delay, were acquired in the same orientation as cine imaging. Each image was divided into eight blocks and a total of 384 blocks were analyzed. Results: First-pass myocardial perfusion defects (PD) were detected in nine patients with an average of 11.5±11 blocks. Delayed contrast enhancement (DE) was detected in 11 patients with an average of 11.5±10 blocks. Mean wall thickness in PD blocks (16.7± 4.7 mm) was larger than that in normal perfusion blocks (13.6±3.9 mm, pº0.001). Mean wall thickness in DE blocks (16.9±4.9 mm) was larger than that in normal enhanced blocks (13.4±3.6 mm, pº0.001). PD were located at almost the same site as DE, but DE areas were larger than PD areas (p=0.0021). Mean percent wall thickening of blocks with PD (63.1±44.7z, pº0.0001) and blocks with DE (75.2±81.5z, pº0.01) was lower than that in blocks with neither PD nor DE (103.5±66.0z). Signiˆcant correlations were found between percent wall thickening and percent PD (r=0.46, pº0.0001) and between percent wall thickening and percent DE (r=0.54, pº0.0001). Conclusion: Abnormal signal intensity fromˆrst-pass myocardial perfusion and delayed contrast-enhanced MRI are closely related to left ventricular regional contractile function.
doi:10.2463/mrms.2.61 pmid:16210822 fatcat:pnavxajab5di5et74gzk3ctqaq