Pharmacokinetic modeling of delayed gadolinium enhancement in the myocardium

Delayed contrast-enhanced magnetic resonance imaging (DCE-MRI) provides prognostic information by delineating regions of myocardial scar. The mechanism of this delayed enhancement in myocardial infarctions (MIs) is hypothesized to result from altered kinetics and changes in the volumes of distribution in the myocardium. Pharmacokinetic models with two and three compartments were fitted to the concentration-time curves of dynamic contrast-enhanced MRI data obtained from five patients with known MI. Furthermore, the parameter stability was investigated in simulations for the two different models. The transfer constants and volumes of distribution showed a good correlation with imaging findings on early and delayed contrast-enhanced MRI. The two compartment model showed higher parameter stability. The three compartment model allows a more in-depth quantification of myocardial scarring. These models have the potential to improve the diagnosis of myocardial pathologies involving scar, with differing kinetics and volumes of distribution such as infarction or cardiomyopathy.