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Prevalence and signal characteristics of late gadolinium enhancement on contrast-enhanced magnetic resonance imaging in patients with takotsubo cardiomyopathy.

AbstractBACKGROUND:
To determine the prevalence and signal intensity (SI) characteristics of late gadolinium enhancement (LGE) on magnetic resonance imaging (MRI) in takotsubo cardiomyopathy (TC).
METHODS AND RESULTS:
Cine, black-blood T2-weighted and LGE MR images were acquired in 23 patients with TC within 72 h of onset. Wall motion abnormality (WMA), edema and LGE were evaluated with a 16-segment model. The SI characteristics of LGE were analyzed using SI distribution in remote normal segments as reference. Follow-up MRI was performed 3 months later. Retrospective analysis of LGE MRI was also performed in 10 patients with acute myocardial infarction (AMI) to compare the SI characteristics between TC and AMI. In acute phase, WMA and edema were observed in 236 (64%) and 205 (56%) of 368 segments. LGE was observed in 10 (2.7%) of 368 segments and in 5 (22%) of 23 patients. All LGE lesions in TC exhibited transmural enhancement. The contrast-to-noise ratio (CNR) in TC was significantly lower than that of AMI (3.1±0.3 standard deviations (SD) vs. 6.1±1.2 SD, P<0.01), and CNR value of 4 was useful for distinguishing TC from AMI. Both LGE and WMA disappeared within 12 months.
CONCLUSIONS:
Grey myocardial signal on LGE MRI may be observed in patients with TC. However, the extent of LGE is substantially less than that of WMA and edema, and disappears within 12 months.
AuthorsShiro Nakamori, Koji Matsuoka, Katsuya Onishi, Tairo Kurita, Yasutaka Ichikawa, Hiroshi Nakajima, Masaki Ishida, Kakuya Kitagawa, Takashi Tanigawa, Tomoaki Nakamura, Masaaki Ito, Hajime Sakuma
JournalCirculation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 76 Issue 4 Pg. 914-21 ( 2012) ISSN: 1347-4820 [Electronic] Japan
PMID22293447 (Publication Type: Journal Article)
Chemical References
  • Contrast Media
  • Gadolinium DTPA
Topics
  • Aged
  • Aged, 80 and over
  • Contrast Media
  • Edema, Cardiac (diagnosis)
  • Female
  • Gadolinium DTPA
  • Humans
  • Japan
  • Magnetic Resonance Imaging, Cine
  • Male
  • Predictive Value of Tests
  • Prognosis
  • Recovery of Function
  • Retrospective Studies
  • Takotsubo Cardiomyopathy (diagnosis, physiopathology)
  • Time Factors
  • Ventricular Function, Left

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