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Comparison of Contrast-Enhanced MRI with Iodine-123 BMIPP for Detection of Myocardial Damage in Hypertrophic Cardiomyopathy

¹ Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
² Department of First Internal Medicine, Nippon Medical School, Tokyo, Japan.

View larger version (118K): [in a new window]   Fig. 1A —24-year-old woman with hypertrophic cardiomyopathy. Contrast-enhanced MR image (A) and SPECT image (B) reveal that hypertrophied interventricular septal and anterior walls show delayed hyperenhancement (arrows, A) and decreased uptake of iodine-123 15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid of myocardium.

View larger version (97K): [in a new window]   Fig. 1B —24-year-old woman with hypertrophic cardiomyopathy. Contrast-enhanced MR image (A) and SPECT image (B) reveal that hypertrophied interventricular septal and anterior walls show delayed hyperenhancement (arrows, A) and decreased uptake of iodine-123 15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid of myocardium.

View larger version (140K): [in a new window]   Fig. 2A —68-year-old woman with hypertrophic cardiomyopathy. Contrast-enhanced MR image shows delayed hyperenhancement. Transmural extent is greater than 50% of interventricular septum (arrow).

View larger version (58K): [in a new window]   Fig. 2B —68-year-old woman with hypertrophic cardiomyopathy. However, iodine-123 15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid SPECT image shows normal uptake.

View larger version (135K): [in a new window]   Fig. 2C —68-year-old woman with hypertrophic cardiomyopathy. Cine MR images obtained at end-diastole (C) and end-systole (D) show hypertrophied interventricular septum.

View larger version (136K): [in a new window]   Fig. 2D —68-year-old woman with hypertrophic cardiomyopathy. Cine MR images obtained at end-diastole (C) and end-systole (D) show hypertrophied interventricular septum.

View larger version (121K): [in a new window]   Fig. 3A —79-year-old woman with hypertrophic cardiomyopathy. Contrast-enhanced MR image shows no delayed hyperenhancement of myocardium.

View larger version (69K): [in a new window]   Fig. 3B —79-year-old woman with hypertrophic cardiomyopathy. However, reduced uptake on SPECT image of iodine-123 15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid, which suggests preceding impairment of fatty acid metabolism, is investigated in interventricular septum.

View larger version (4K): [in a new window]   Fig. 4 —Graph shows correlation between number of segments with delayed hyperenhancement and left ventricular ejection fraction. There was inverse correlation between number of hyperenhancing segments and left ventricular ejection fraction in 21 of 23 hypertrophic cardiomyopathy patients with high value of ejection fraction (p = 0.012; r = –0.53; Y = –1.47 x X + 81.98). Vertical line = left ventricular ejection fraction, diagonal line = number of hyperenhancing segments.

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