Performance of Delayed-Enhancement Magnetic Resonance Imaging With Gadoversetamide Contrast for the Detection and Assessment of Myocardial Infarction : An International, Multicenter, Double-Blinded, Randomized Trial

• Published in: Circulation (New York, N.Y.) N.Y.), 2008-02, Vol.117 (5), p.629-637
• Main Authors: KIM, Raymond J, ALBERT, Timothy S. E, WIBLE, James H, ELLIOTT, Michael D, ALLEN, John C, LEE, Jennifer C, PARKER, Michele, NAPOLI, Alicia, JUDD, Robert M
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Aged; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular system; Chronic Disease; Contrast Media; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Double-Blind Method; Europe; Female; Humans; Image Enhancement - methods; Magnetic Resonance Imaging - methods; Male; Medical sciences; Middle Aged; Myocardial Infarction - diagnosis; Organometallic Compounds - therapeutic use; Patient Selection; Pharmacology. Drug treatments; Sensitivity and Specificity; South America; United States; Vasodilator agents. Cerebral vasodilators
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/CIRCULATIONAHA.107.723262

The identification and assessment of myocardial infarction (MI) are important for therapeutic and prognostic purposes, yet current recommended diagnostic strategies have significant limitations. We prospectively tested the performance of delayed-enhancement magnetic resonance imaging (MRI) with gadolinium-based contrast for the detection of MI in an international, multicenter trial. Patients with their first MI were enrolled in an acute (< or = 16 days after MI; n=282) or chronic (17 days to 6 months; n=284) arm and then randomized to 1 of 4 doses of gadoversetamide: 0.05, 0.1, 0.2, or 0.3 mmol/kg. Standard delayed-enhancement MRI was performed before contrast (control) and 10 and 30 minutes after gadoversetamide. For blinded analysis, precontrast and postcontrast MRIs were randomized and then scored for enhanced regions by 3 independent readers not associated with the study. The infarct-related artery perfusion territory was scored from x-ray angiograms separately. In total, 566 scans were performed in 26 centers using commercially available scanners from all major US/European vendors. All scans were included in the analysis. The sensitivity of MRI for detecting MI increased with rising dose of gadoversetamide (P