MRI for the assessment of myocardial viability.
Accurate distinction between viable and infarcted myocardium is important for assessment of patients who have cardiac dysfunction. Through the technique of delayed-enhancement MRI (DE-MRI), viable and infarcted myocardium can be simultaneously identified in a manner that closely correlates with histopathology findings. This article provides an overview of experimental data establishing the physiologic basis of DE-MRI-evidenced hyperenhancement as a tissue-specific marker of myocardial infarction. Clinical data concerning the utility of transmural extent of hyperenhancement for predicting response to medical and revascularization therapy are reviewed. Studies directly comparing DE-MRI to other viability imaging techniques are presented, and emerging applications for DE-MRI are discussed.
Weinsaft
Jonathan W
JW
Greenberg Division of Cardiology, Weill Medical College of Cornell University, 525 East 68th Street, Starr-4, New York, NY 10021, USA. jww2001@med.cornell.edu
Klem
Igor
I
Judd
Robert M
RM
D000818:Animals; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology; D025401:Echocardiography, Stress; D006333:Heart Failure / Q000473:pathology; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods*; D017202:Myocardial Ischemia / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed