Relationship Between Thrombolytic Therapy and Perfusion Defect Detected by Gd-DTPA–Enhanced Fast Magnetic Resonance Imaging in Acute Myocardial Infarction

To study whether thrombolytic therapy affects Gd-DTPA–enhanced pattern and whether its pattern indicates myocardial viability, Gd-DTPA–enhanced magnetic resonance imaging (MRI) was performed in 43 patients with reperfused acute myocardial infarction 14.8 ± 5.0 days after onset with breathhold scanning on a 1.5-T whole body system. The hypoenhanced area at 90 sec after contrast injection was defined as a perfusion defect (PD). Patients were divided into PD (+) and PD (−) groups. The PD was detected in 77.8% of patients treated with direct percutaneous transluminal coronary angioplasty (PTCA) and in 28.6% of patients treated by thrombolytic therapy with or without PTCA in the thrombolysis in myocardial infarction grade 3 group (p < 0.05). The myocardial wall was divided into seven segments based on the American Heart Association committee report. Wall motion of each segment was classified by one of six patterns (wall motion score [WMS]: dyskinesis, −1; akinesis, 0; severe hypokinesis, 1; hypokinesis, 2; sli...