Type:
Educational Exhibit
Keywords:
Cardiac, MR, Imaging sequences, Diagnostic procedure, Inflammation, Connective tissue disorders, Congenital
Authors:
A. Mirakhur, N. Merchant; Calgary, AB/CA
DOI:
10.1594/ecr2013/C-2257
Background
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 [1],
delayed enhancement CMR has now become the standard of reference for evaluation of myocardial scar due to infarction.
Delayed myocardial enhancement is,
however,
not specific for myocardial infarction (MI) and can occur in a variety of non-ischemic cardiac conditions.
Differential myocardial contrast enhancement forms the basis of tissue characterization and is seen in many pathophysiologic scenarios other than MI: increased volume of contrast material distribution in inflammatory or infectious conditions,
retention of contrast material by fibrous tissue in infiltrative and cardiomyopathic conditions.
Because it allows differentiation among diagnoses based on the different patterns of delayed enhancement,
LGE is being increasingly used for the assessment of non-ischemic cardiac conditions,
such as dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM).
However,
LGE is also a feature of a number of rare cardiomyopathic conditions and infiltrative/inflammatory myocardial diseases.