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DOI:10.2214/AJR.07.2518
AJR 2008; 191:73-79
© American Roentgen Ray Society


Pictorial Essay

No-Reflow Phenomenon in Cardiac MRI: Diagnosis and Clinical Implications

Víctor Pineda1, Xavier Merino1, Susana Gispert1, Patricia Mahía2, Bruno Garcia2 and Rosa Domínguez-Oronoz1

1 Department of Radiology, Unitat de Ressonància Magnètica, Hospital General Vall d'Hebron, Pg. De la Vall d'Hebron 119-129, 08035 Barcelona, Spain.
2 Cardiology Department, Hospital General Vall d'Hebron, Barcelona, Spain.

OBJECTIVE. The purposes of this study were to depict the first-pass, delayed contrast enhancement and regional myocardial wall motion abnormalities of no-reflow phenomenon MRI and to review the major mechanisms and significance of this phenomenon in the clinical setting.

CONCLUSION. Contrast-enhanced MRI is a useful noninvasive technique for determining the presence of microvascular obstruction. No-reflow phenomenon has important prognostic implications, and knowledge of the physiologic mechanism is important to understanding the distribution patterns of enhancement in correlation with the underlying pathologic process.

Keywords: cardiovascular imaging • delayed contrast enhancement • MRI


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