Cardiovascular MRI: The Future is Now - Washington Hospital Center

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Viability by CMR Late gadolinium enhancement Dobutamine – contractile reserve Techniques Applications – acute MI, chronic <strong>is</strong>chemia Prognos<strong>is</strong>
Infarct detection/transmurality Technique - inversion recovery, nulling of normal myocardial signal Infuse 0.15 mM/kg of Gd-DTPA Image 10-20 minutes later – Gd becomes trapped in necrotic scar, delayed washout Simonetti et al Radiology 2001;218:215
Page 1 and 2: Assessment of Viability with CMR: W
Page 3 and 4: Viability testing and outcomes Annu
Page 5 and 6: STICH Trial Velasquez EJ et al, NEJ
Page 7: Limitations of STICH Crossover in 1
Page 11 and 12: Size of HE Choi et al Circulation 2
Page 13 and 14: Reproducibility 48 pts., 3 centers
Page 15 and 16: SPECT vs. CMR 78 pts. acute MI at d
Page 17 and 18: LGE and prognosis Kwong, RY et al.
Page 19 and 20: Regional function %S 30 25 20 15 10
Page 21 and 22: Time to reperfusion Tarantini G et
Page 23 and 24: AMI - T2-W edema imaging - area at
Page 25 and 26: T2-W - edema/area at risk
Page 27 and 28: Hibernation - Late gadolinium enhan
Page 29 and 30: LGE vs. PET 31 pts., ischemic LV dy
Page 31 and 32: Viability - Late gadolinium enhance
Page 33 and 34: Viability - dobutamine tagged MRI 1
Page 35 and 36: Example images - nonviable segment
Page 37 and 38: Contrast vs. dobutamine All segment
Page 39: Conclusions If viability is of inte

Cardiovascular MRI: The Future is Now - Washington Hospital Center

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