To briefly describe the technique of delayed enhancement cardiac magnetic resonance (CMR) imaging. 2.
To discuss pathophysiology and patterns of late gadolinium enhancement (LGE) in a myriad of uncommon non-ischemic cardiomyopathies,
congenital cardiac conditions,
as well as inflammatory and infiltrative myocardial disease.
These include endocardial fibroelastosis,
collagen vascular diseases such as scleroderma,
as well as...
CMR permits optimal differentiation between normal and diseased myocardium with the use of gadolinium-based contrast agents and specific pulse sequences.
First described more than 10 years ago ,
delayed enhancement CMR has now become the standard of reference for evaluation of myocardial scar due to infarction.
Delayed myocardial enhancement is,
not specific for myocardial infarction (MI) and can occur in a variety of non-ischemic cardiac conditions.
Imaging findings OR Procedure details
The technique for LGE-CMR involves intravenous administration of gadolinium chelate contrast material (0.05-0.2 mmol/kg) followed 8-30 minutes later by a cardiac-gated T1-weighted pulse sequence.
The typical LGE pulse sequence is a cardiac-gated segmented inversion-recovery-prepared fast gradient-echo sequence: an inversion recovery preparatory pulse nulls normal myocardium,
followed by a segmented k-space gradient-echo acquisition.
Retention of contrast material results in T1 shortening and...
Due to its superior spatial resolution as well as its capabilities for cardiac anatomical and physiological assessment,
LGE-CMR imaging has become the preferred tool to determine the presence and extent of myocardial disease.
While LGE CMR has become fairly well established for imaging of acute and chronic MI and relatively more common non-ischemic cardiomyopathies such as HCM and DCM,
delayed myocardial enhancement can be seen in many other lesser known cardiac pathologic conditions.
MR imaging of the myocardium using non-ionic contrast medium: signal-intensity changes in patients with subacute myocardial infarction.
AJR Am J Roentgenol 1993; 160:963–970. Kellman P,
Phase-sensitive inversion recovery for detecting myocardial infarction using gadolinium-delayed hyperenhancement.
Magn Reson Med 2002; 47:372-383. Vogel-Claussen J,
Delayed Enhancement MR Imaging: Utility in...