http://www.thepreparedminds.com/archives/614 In the field of observation, chance favors the prepared minds. Sat, 04 Feb 2012 14:45:45 +0000 hourly 1 http://wordpress.org/?v=3.3 http://www.thepreparedminds.com/archives/614/comment-page-1#comment-476 Jacobo Kirsch, MD Mon, 23 Nov 2009 18:01:53 +0000 http://www.thepreparedminds.com/?p=614#comment-476 The presence and amount of MVO has been associated with LV remodeling after an AMI. A <a href="http://www.thepreparedminds.com/archives/65" rel="nofollow">recent paper</a> also associated it with major adverse cardiac events. In this study, the authors use an earlier (2 min) acquisition version of a delayed enhancement sequence to assess the amount of MVO and its change when compared to a more conventional (10 min) delayed enhancement sequence. (They first do a pilot sub-study to determine the time of inversion to be used at 2 min after administration of contrast - which turns out to be 530 msec.) The results show a dynamic change in the appearance of MVO over time, with the conventional 10 min delayed underestimating the size of MVO. As they point out, the MR technique that has been correlated with histopathological studies and radioactive flow measurements is First Pass perfusion; it is interesting that their 2 min sequence was not directly compared to a FP sequence in this exam (allowing for the limitations that FP has for not visualizing the entire LV). The same <a href="http://www.thepreparedminds.com/archives/65" rel="nofollow">paper</a> referenced above demonstrated that 10 min delayed enhancement underestimates MVO when compared to FP sequences. The presence and amount of MVO has been associated with LV remodeling after an AMI. A recent paper also associated it with major adverse cardiac events.
In this study, the authors use an earlier (2 min) acquisition version of a delayed enhancement sequence to assess the amount of MVO and its change when compared to a more conventional (10 min) delayed enhancement sequence. (They first do a pilot sub-study to determine the time of inversion to be used at 2 min after administration of contrast – which turns out to be 530 msec.)
The results show a dynamic change in the appearance of MVO over time, with the conventional 10 min delayed underestimating the size of MVO. As they point out, the MR technique that has been correlated with histopathological studies and radioactive flow measurements is First Pass perfusion; it is interesting that their 2 min sequence was not directly compared to a FP sequence in this exam (allowing for the limitations that FP has for not visualizing the entire LV).
The same paper referenced above demonstrated that 10 min delayed enhancement underestimates MVO when compared to FP sequences.

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