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European Heart Journal Advance Access originally published online on June 2, 2006
European Heart Journal 2006 27(13):1620-1626; doi:10.1093/eurheartj/ehl059
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Magnetic resonance imaging of haemorrhage within reperfused myocardial infarcts: possible interference with iron oxide-labelled cell tracking?

Ewout J. van den Bos1, Timo Baks1,2, Amber D. Moelker1, Wendy Kerver1, Robert-Jan van Geuns2, Willem J. van der Giessen1, Dirk J. Duncker1 and Piotr A. Wielopolski2,*

1 Cardiovascular Research School Coeur, Experimental Cardiology, Thoraxcenter, Erasmus MC University Medical Center, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
2 Department of Radiology, Erasmus MC University Medical Center, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands

Received 17 November 2005; revised 3 May 2006; accepted 12 May 2006; online publish-ahead-of-print 2 June 2006.

* Corresponding author. Tel: +31 10 4088001; fax: +31 10 4634033. E-mail address: p.wielopolski{at}erasmusmc.nl

Aims Magnetic resonance imaging (MRI) has been proposed as a tool to track iron oxide-labelled cells within myocardial infarction (MI). However, infarct reperfusion aggravates microvascular obstruction (MO) and causes haemorrhage. We hypothesized that haemorrhagic MI causes magnetic susceptibility-induced signal voids that may interfere with iron oxide-labelled cell detection.

Methods and results Pigs (n = 23) underwent 2 h occlusion of the left circumflex artery. Cine, T2*-weighted, perfusion, and delayed enhancement MRI scans were performed at 1 and 5 weeks, followed by ex vivo high-resolution scanning. At 1 week, MO was observed in 17 out of 21 animals. Signal voids were observed on T2*-weighted scans in five out of eight animals, comprising 24±22% of the infarct area. A linear correlation was found between area of MO and signal voids (R2 = 0.87; P = 0.002). At 5 weeks, MO was observed in two out of 13 animals. Signal voids were identified in three out of seven animals. Ex vivo scanning showed signal voids on T2*-weighted scanning in all animals because of the presence of haemorrhage, as confirmed by histology. Signal voids interfered with the detection of iron oxide-labelled cells ex vivo (n = 21 injections).

Conclusion Haemorrhage in reperfused MI produces MRI signal voids, which may hamper tracking of iron oxide-labelled cells.

Key Words: Magnetic resonance imaging • Myocardial infarction • Haemorrhage • Cells • Iron oxide particles


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