HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lim, R. P. Articles by Lee, V. S. Search for Related Content PubMed PubMed Citation Articles by Lim, R. P. Articles by Lee, V. S. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Non-Ischemic Causes of Delayed Myocardial Hyperenhancement on MRI

¹ All authors: Department of Radiology – MRI, New York University Medical Center, 530 First Ave., New York, NY 10016.

View larger version (179K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1 —75-year-old man with known coronary artery disease. Short-axis true fast imaging with steady-state precession phase-sensitive inversion-recovery image shows two hyperenhancing near-transmural infarct areas involving left ventricular basal anterior and anteroseptal segments (arrow) and basal inferolateral segment (arrowhead). These areas correspond to 100% occluded proximal left anterior descending artery and diffuse disease of both left circumflex artery and right coronary artery at coronary angiography (not shown).

View larger version (196K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —42-year-old man with known hypertrophic cardiomyopathy. Short-axis inversion-recovery turbo FLASH image obtained using 3.0-T scanner 10 minutes after gadolinium administration shows patchy subendocardial septal enhancement at mid ventricular level (arrow).

View larger version (187K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —42-year-old man with known hypertrophic cardiomyopathy. Three-chamber contrast-enhanced inversion-recovery turbo FLASH image again shows delayed mid anteroseptal hyperenhancement (arrowhead). Asymmetric septal hypertrophy (arrow) is better seen on this view than on A.

View larger version (139K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3 —45-year-old man with non-ischemic dilated cardiomyopathy. Two-chamber segmented turbo FLASH image obtained 10 minutes after contrast administration shows anterior wall linear hyperenhancement sparing subendocardium and subepicardium (arrow).

View larger version (178K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —37-year-old man with arrhythmogenic right ventricular cardiomyopathy presenting with syncope and T-wave inversion in precordial leads. (Courtesy of David Bluemke, John Hopkins University School of Medicine, Baltimore, MD) Delayed contrast-enhanced short-axis image shows enhancement of right ventricular free wall (arrow) and involvement of left ventricle (arrowhead).

View larger version (154K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —37-year-old man with arrhythmogenic right ventricular cardiomyopathy presenting with syncope and T-wave inversion in precordial leads. (Courtesy of David Bluemke, John Hopkins University School of Medicine, Baltimore, MD) Axial dark-blood T1-weighted image obtained before contrast administration shows high signal consistent with fat within right ventricular free wall (arrow) and left ventricular lateral wall (arrowhead).

View larger version (174K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5A —58-year-old man with sarcoidosis presenting with ventricular tachycardia. Three-chamber turbo FLASH single-shot phase-sensitive inversion-recovery image at 10 minutes after contrast injection shows delayed hyperenhancement in mid wall involving basal inferolateral segment (arrow).

View larger version (185K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5B —58-year-old man with sarcoidosis presenting with ventricular tachycardia. Three-chamber unenhanced dark-blood turbo spin-echo T2-weighted image shows slightly more distal T2 hyperintensity in mid inferolateral wall (arrow) that indicates inflammation.

View larger version (209K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6 —76-year-old man with systemic amyloidosis. Two-chamber delayed contrast-enhanced image shows diffuse linear enhancement of left ventricle (arrow). (Courtesy of Rajiv Agarwal, Cleveland Clinic Foundation, Cleveland, OH)

View larger version (174K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7A —63-year-old woman with eosinophilic leukemia and thrombotic–necrotic stage of Loeffler's endomyocarditis. Short-axis true fast imaging with steady-state precession (FISP) phase-sensitive inversion-recovery (PSIR) image at 10 minutes after contrast administration shows confluent subendocardial hyperenhancement of all apical segments involving less than 50% of wall thickness (arrowheads).

View larger version (169K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7B —63-year-old woman with eosinophilic leukemia and thrombotic–necrotic stage of Loeffler's endomyocarditis. Four-chamber true FISP PSIR image shows extent of subendocardial involvement, extending proximally to involve mid inferoseptal (white arrowhead) and basal and mid anterolateral segments (black arrowheads). There is hyperenhancement of apical right ventricular free wall (arrow).

View larger version (173K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7C —63-year-old woman with eosinophilic leukemia and thrombotic–necrotic stage of Loeffler's endomyocarditis. Four-chamber dark-blood T2 fast spin-echo image shows corresponding T2 hyperintensity (thick arrow) where delayed hyperenhancement is present in B and ancillary findings of apical left lower lobe consolidation (thin arrow) and pericardial effusion (arrowheads).

View larger version (162K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7D —63-year-old woman with eosinophilic leukemia and thrombotic–necrotic stage of Loeffler's endomyocarditis. Three-chamber true FISP PSIR image shows 1-cm nonenhancing focus overlying basal inferolateral endocardium (arrow), which is consistent with small left ventricular thrombus.

View larger version (153K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8A —52-year-old woman presenting with recurrent tachyarrhythmia after undergoing right ventricular outflow tract radiofrequency ablation. Delayed contrast-enhanced turbo FLASH inversion-recovery horizontal long-axis image shows hyperenhancement of right ventricular outflow tract close to interventricular septum at site of prior ablation (arrow).

View larger version (151K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8B —52-year-old woman presenting with recurrent tachyarrhythmia after undergoing right ventricular outflow tract radiofrequency ablation. Cine true fast imaging with steady-state precession vertical long-axis image through right ventricle shows focal outpouching (arrow) in systole, which is consistent with dyskinesis at site of radiofrequency ablation.

View larger version (179K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9A —17-year-old boy with chest pain, inferior and lateral ST-elevation ECG changes, and elevated troponin with normal findings on coronary angiography. Four-chamber segmented turbo FLASH inversion-recovery image obtained 10 minutes after contrast administration shows patchy foci of hyperenhancement subepicardially involving mid and apical lateral left ventricular wall (arrows).

View larger version (175K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9B —17-year-old boy with chest pain, inferior and lateral ST-elevation ECG changes, and elevated troponin with normal findings on coronary angiography. Short-axis view at mid level again shows subepicardial nature of inferolateral wall hyperenhancement (arrow). Multiple vascular territories and nonsubendocardial involvement are typical of myocarditis.

View larger version (146K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 10A —18-year-old asymptomatic man with heart murmur at physical examination and fibroma at surgery. Two-chamber phase-sensitive inversion-recovery contrast-enhanced delayed phase image shows intensely enhancing well-circumscribed mass involving mid to apical anterior left ventricular wall (arrow) with small nonenhancing central focus. Pericardial effusion is also present.

View larger version (187K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 10B —18-year-old asymptomatic man with heart murmur at physical examination and fibroma at surgery. Corresponding short-axis magnitude image confirms intramyocardial location of mass with thin rim of circumferential myocardium (arrowheads). There is left ventricular cavity deformation.

View larger version (179K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 10C —18-year-old asymptomatic man with heart murmur at physical examination and fibroma at surgery. Unenhanced cine true fast imaging with steady-state precession short-axis systolic image shows mass is isointense to myocardium, a mimic for hypertrophic cardiomyopathy.

View larger version (198K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 11A —67-year-old woman with history of metastatic renal cell carcinoma. Sagittal HASTE image shows soft-tissue mass (arrow) involving right ventricular free wall anteriorly.

View larger version (190K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 11B —67-year-old woman with history of metastatic renal cell carcinoma. Tagged FLASH image shows noncontractile mass with no deformation of grid tags within mass (arrow) compared with normal myocardium (arrowheads).

View larger version (170K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 11C —67-year-old woman with history of metastatic renal cell carcinoma. Four-chamber segmented true fast imaging with steady-state precession inversion-recovery image obtained 10 minutes after contrast administration shows vivid hyperenhancement of mass (arrow), with small focus of necrosis, and tiny right ventricular mural thrombus (arrowhead).

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati