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Delayed Enhancement MR Imaging: Utility in Myocardial Assessment¹

¹ From the Departments of Radiology (J.V.C., I.R.K., J.A.C.L., D.A.B.) and Cardiology (K.C.W., J.A.C.L., D.A.B.), Johns Hopkins Hospital, MRI, Room 143 (Nelson Basement), 600 N Wolfe St, Baltimore, MD 21287; the Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil (C.E.R.); and GE Health Systems, Baltimore, Md (T.K.F.). Recipient of a Certificate of Merit award for an education exhibit at the 2004 RSNA Annual Meeting. Received March 10, 2005; revision requested June 8 and received July 29; accepted August 9. The authors discuss an investigational or unlabeled use of a commercial product, device, or pharmaceutical that has not been approved for such purpose by the FDA. T.K.F. is an employee of GE Health Systems; J.A.C.L. is a member of the speakers bureau of GE Healthcare, Waukesha, Wis; all other authors have no financial relationships to disclose. Address correspondence to D.A.B. (e-mail: dbluemke{at}jhmi.edu).

Use of magnetic resonance (MR) imaging for diagnosis of cardiac diseases and treatment monitoring is expanding. Delayed myocardial enhancement MR imaging is performed after administration of paramagnetic contrast agents and is used for a growing number of clinical applications. This technique was developed primarily for characterization of myocardial scarring after myocardial infarction. On delayed enhancement MR images, scarring or fibrosis appears as an area of high signal intensity that is typically subendocardial or transmural in a coronary artery distribution. However, delayed myocardial enhancement is not specific for myocardial infarction and can occur in a variety of other disorders, such as inflammatory or infectious diseases of the myocardium, cardiomyopathy, cardiac neoplasms, and congenital or genetic cardiac conditions, as well as after cardiac interventions. In nonischemic myocardial disease, the delayed enhancement usually does not occur in a coronary artery distribution and is often midwall rather than subendocardial or transmural. Therefore, the patient’s clinical history is critical in the evaluation of delayed myocardial enhancement MR images.

© RSNA, 2006

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