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Analysis of First-Pass and Delayed Contrast-Enhancement Patterns of Dysfunctional Myocardium on MR Imaging

Use in the Prediction of Myocardial Viability

Jörn J. W. Sandstede1, Claudia Lipke1, Meinrad Beer1, Kerstin Harre2, Thomas Pabst1, Werner Kenn1, Stefan Neubauer2 and Dietbert Hahn1

1 Department of Radiology, Universität Würzburg, Josef-Schneider-Str. 2, D-97080 Würzburg, Germany.
2 Department of Internal Medicine, Universität Würzburg, D-97080 Würzburg, Germany.



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  		Fig. 1A. —49-year-old man with recovery from acute myocardial infarction (arrows, A-F). Two-dimensional cine fast low-angle shot MR images at midventricular short-axis view obtained 24 days after myocardial infarction show wall motion defect of anteroseptal wall from diastole (A) to systole (B).

 


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  		Fig. 1B. —49-year-old man with recovery from acute myocardial infarction (arrows, A-F). Two-dimensional cine fast low-angle shot MR images at midventricular short-axis view obtained 24 days after myocardial infarction show wall motion defect of anteroseptal wall from diastole (A) to systole (B).

 


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  		Fig. 1C. —49-year-old man with recovery from acute myocardial infarction (arrows, A-F). T1-weighted turbo fast low-angle shot MR image reveals hypoenhancement of this region during first-pass of gadopentetate dimeglumine.

 


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  		Fig. 1D. —49-year-old man with recovery from acute myocardial infarction (arrows, A-F). T1-weighted turbo fast low-angle shot MR image obtained 15 min after injection shows delayed hyperenhancement compared with adjacent lateral and inferior wall. This hyperenhancement is less distinct than average hyperenhancement of nonviable segments at study entry.

 


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  		Fig. 1E. —49-year-old man with recovery from acute myocardial infarction (arrows, A-F). Two-dimensional cine fast low-angle shot MR image obtained 3 months after percutaneous transluminal coronary angioplasty of infarct-related left anterior descending coronary artery with stent implantation proves unchanged wall motion defect at systole as sign of scarred tissue.

 


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  		Fig. 1F. —49-year-old man with recovery from acute myocardial infarction (arrows, A-F). T1-weighted turbo fast low-angle shot MR image obtained 15 min after injection of gadopentetate dimeglumine still reveals delayed hyperenhancement. This hyperenhancement is more distinct than average hyperenhancement of nonviable segments at follow-up.

 

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