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European Heart Journal Advance Access published online on June 2, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl059
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received November 17, 2005
Revised May 3, 2006
Accepted May 12, 2006

Preclinical research

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

Ewout J. van den Bos 1, Timo Baks 2, Amber D. Moelker 1, Wendy Kerver 1, Robert-Jan van Geuns 3, Willem J. van der Giessen 1, Dirk J. Duncker 1, and Piotr A. Wielopolski 3 *

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

* To whom correspondence should be addressed.
Piotr A. Wielopolski, E-mail: p.wielopolski{at}erasmusmc.nl


  Abstract

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.

Keywords: Magnetic resonance imaging; Myocardial infarction; Haemorrhage; Cells; Iron oxide particles.
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