MEMRI (manganese enhanced MRI)
DOMAIN Within an ageing population, ischemic heart disease (IHD) and secondary heart failure represent major challenges underlining a demand for diagnostic imaging to identify IHD in its different stages and forms. There is also a need to diagnose heart failure developing after myocardial infarction, to identify other forms of heart failure, and to monitor the efficacy of drug treatment.
The seriousness and the epidemic nature of ischemic heart disease call for effective diagnostic methods to identify, at an early stage, the individual patients at risk and to improve the follow-up of their treatment.
Diagnostic imaging has developed greatly in the last decades but no technical modality can yet cover the whole spectrum of diagnostic needs. Magnetic resonance (MR) imaging (MRI) is most promising with its overall versatility in free choice of image sections and in signalling techniques.
There is a need in the field for a method for obtaining essentially new information derived from the intracellular (IC) space with its biochemical and physiological machinery.
DESCRIPTION NTNU researchers have developed a new MRI method for assessment of myocardial ischemia and of myocardial function, viability and perfusion. The intravenous infusion of manganese contrast media that release divalent and paramagnetic Mn ions introduces intracellular contrast agents into cardiac cells. The method comprises the separate detection of T1 and T2 relaxivities and water diffusion for differentiating IC water compartments from extra-cellular (EC) water compartments in the myocardium.
“Stress tests” have also been developed to make defects in function and perfusion in ischemic regions of the myocardium more visible since these are not easily detected under resting conditions. The stress may be elicited by any kind of physical exercise, like in bicycle ergometry and ECG testing, or by the use of pharmaceuticals. Intravenous infusion of drugs that increase cardiac work or decrease myocardial blood flow to the ischemic region are commonly applied, irrespective of imaging modality. Imaging or intravenous injection of a myocardial marker are undertaken at the height of stress.
UNIQUE SELLING POINTS • Identifies regions with high viability
• Optimally combines cardiac MRI and intracellular Mn ions with physical or pharmaceutical stress
• Increases signal intensity and contrast in MR images
POTENTIAL APPLICATIONS • Cardiac MRI
STATE OF DEVELOPMENT • Ongoing experimental and clinical studies at St. Olavs Hospital
Per Jynge, Heidi Brurok, Wibeke Nordhøy, Morten Bruvold, John G. Seland, Jostein Krane, Henrik W. Anthonsen
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