Ferumoxytol-enhanced Cardiac MRI for Delineation of Intramyocardial Hemorrhage

Motivation: Intramyocardial hemorrhage (IMH) frequently occurs in acute myocardial infarction (AMI) and is associated with adverse outcomes. While T2* cardiac magnetic resonance (CMR) imaging has emerged as the reference standard for noninvasive IMH detection, it relies on the paramagnetic properties of hemoglobin breakdown products, usually detectable between 1 and 3 days following IMH. Goal(s): We demonstrate an alternative approach that can more promptly detect active myocardial bleeding. Approach: We leveraged the T1 shortening effects of intravascular ferumoxytol to identify IMH following acute ischemia-reperfusion injury. Results: Ferumoxytol-enhanced CMR depiction of IMH were in agreement with gross and histologic evaluations. Impact: We demonstrate the effectiveness of ferumoxytol-enhanced cardiovascular magnetic resonance (FE-CMR) in detecting active intramyocardial hemorrhage after ischemia-reperfusion injury. This may facilitate the development, testing, and clinical adoption of strategies to mitigate IMH-associated complications.