title: Prevalence and signal characteristics of late gadolinium enhancement on contrast-enhanced magnetic resonance imaging in patients with takotsubo cardiomyopathy.
abstract: BACKGROUND
  To determine the prevalence and signal intensity (SI) characteristics of late gadolinium enhancement (LGE) on magnetic resonance imaging (MRI) in takotsubo cardiomyopathy (TC).
  
  
  RESULTS
  Cine, black-blood T2-weighted and LGE MR images were acquired in 23 patients with TC within 72 h of onset. Wall motion abnormality (WMA), edema and LGE were evaluated with a 16-segment model. The SI characteristics of LGE were analyzed using SI distribution in remote normal segments as reference. Follow-up MRI was performed 3 months later. Retrospective analysis of LGE MRI was also performed in 10 patients with acute myocardial infarction (AMI) to compare the SI characteristics between TC and AMI. In acute phase, WMA and edema were observed in 236 (64%) and 205 (56%) of 368 segments. LGE was observed in 10 (2.7%) of 368 segments and in 5 (22%) of 23 patients. All LGE lesions in TC exhibited transmural enhancement. The contrast-to-noise ratio (CNR) in TC was significantly lower than that of AMI (3.1±0.3 standard deviations (SD) vs. 6.1±1.2 SD, P<0.01), and CNR value of 4 was useful for distinguishing TC from AMI. Both LGE and WMA disappeared within 12 months.
  
  
  CONCLUSIONS
  Grey myocardial signal on LGE MRI may be observed in patients with TC. However, the extent of LGE is substantially less than that of WMA and edema, and disappears within 12 months.
authors.affiliation: Department of Cardiology, Matsusaka Central Hospital, Matsusaka, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Nakamori
authors.forename: Koji
authors.initials: K
authors.lastname: Matsuoka
authors.forename: Katsuya
authors.initials: K
authors.lastname: Onishi
authors.forename: Tairo
authors.initials: T
authors.lastname: Kurita
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Ichikawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakajima
authors.forename: Masaki
authors.initials: M
authors.lastname: Ishida
authors.forename: Kakuya
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanigawa
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Nakamura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
authors.forename: Hajime
authors.initials: H
authors.lastname: Sakuma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D004489:Edema, Cardiac / Q000175:diagnosis; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007564:Japan; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000503:physiopathology; D013997:Time Factors; D016277:Ventricular Function, Left
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA