Assessment of cardiac rejection by MR-imaging and MR-spectroscopy

Walpoth, Beat H.; Müller, Markus F.; Celik, Bülent; Nicolaus, Beatrice; Walpoth, Nazan; Schaffner, Thomas; Althaus, Ulrich; Carrel, Thierry (1998). Assessment of cardiac rejection by MR-imaging and MR-spectroscopy. European journal of cardio-thoracic surgery, 14(4), pp. 426-430. Elsevier Science B.V. 10.1016/S1010-7940(98)00202-4

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Background: Detection of cardiac rejection is a major problem in cardiac transplantation. The gold standard is, and remains, endomyocardial biopsy. Purpose: Evaluation of MR-imaging and MR-spectroscopy for detection of cardiac rejection. Methods: Orthotopic cardiac transplantation (HTX) was performed in 13 pigs (body weight 30 kg). All animals obtained immunosuppressive (triple) therapy for 1 week after the operation. Thereafter immunosuppression was stopped to induce cardiac rejection. MRI and MRS (1.5 Tesla General Electrics Signa) were performed pre- and post-operatively on days 10, 17, 24 and 31. The degree of rejection was determined post-operatively using endomyocardial biopsy (Texas grading score). Results: (1) MR-imaging: LV function remained unchanged after HTX. LV mass increased (+42%; P<0.05) with cardiac rejection. (2) MR-spectroscopy: a marked reduction in the ratio of phosphocreatine and adenosine triphosphate, respectively, to inorganic phosphate was observed in the rejecting hearts. (3) Histologic grading confirmed cardiac rejection after stopping immunosuppression. The Texas score was 5.7±0.8 at autopsy. Conclusions: MR-imaging and MR-spectroscopy allow the detection of changes associated with cardiac rejection. Both techniques are correlated with histologic rejection. However, endomyocardial biopsy remains the gold standard for reliable detection of cardiac rejection.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Thoracic Surgery
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Service Sector > Institute of Pathology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Walpoth, Belinda Nazan, Schaffner, Thomas, Althaus, Ulrich, Carrel, Thierry


600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology




Elsevier Science B.V.




Marceline Brodmann

Date Deposited:

05 Oct 2020 10:45

Last Modified:

05 Dec 2022 15:13

Publisher DOI:





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