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 (R 2 = 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.

Cells, Haemorrhage, Iron oxide particles, Magnetic resonance imaging, Myocardial infarction,
European Heart Journal
Department of Cardiology

van den Bos, E.J, Baks, T, Moelker, A.D, Kerver, W, van Geuns, R.J.M, van der Giessen, W.J, … Wielopolski, P.A. (2006). Magnetic resonance imaging of haemorrhage within reperfused myocardial infarcts: Possible interference with iron oxide-labelled cell tracking?. European Heart Journal, 27(13), 1620–1626. doi:10.1093/eurheartj/ehl059