title: Intramyocardial hemorrhage: an enigma for cardiac MRI?
abstract: Cardiovascular magnetic resonance (CMR) is a useful noninvasive technique for determining the presence of microvascular obstruction (MVO) and intramyocardial hemorrhage (IMH), frequently occurring in patients after reperfused myocardial infarction (MI). MVO, or the so-called no-reflow phenomenon, is associated with adverse ventricular remodeling and a poor prognosis during follow-up. Similarly, IMH is considered a severe damage after revascularization by percutaneous primary coronary intervention (PPCI) or fibrinolysis, which represents a worse prognosis. However, the pathophysiology of IMH is not fully understood and imaging modalities might help to better understand that phenomenon. While, during the past decade, several studies examined the distribution patterns of late gadolinium enhancement with different CMR sequences, the standardized CMR protocol for assessment of IMH is not yet well established. The aim of this review is to evaluate the available literature on this issue, with particular regard to CMR sequences. New techniques, such as positron emission tomography/magnetic resonance imaging (PET/MRI), could be useful tools to explore molecular mechanisms of the myocardial infarction healing process.
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, La Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Camilla
authors.identifier: 0000-0001-6548-3400
authors.initials: C
authors.lastname: Calvieri
authors.affiliation: Department of Radiology, La Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Masselli
authors.affiliation: Department of Radiology, La Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Monti
authors.affiliation: Department of Radiology, La Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Spreca
authors.affiliation: Department of Radiology, La Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gualdi
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, La Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Francesco
authors.identifier: 0000-0003-2567-7918
authors.initials: F
authors.lastname: Fedele
mesh_terms: D000818:Animals; D003287:Contrast Media / Q000494:pharmacology; D003326:Coronary Circulation / Q000502:physiology; D006470:Hemorrhage / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009203:Myocardial Infarction / Q000473:pathology*; D009206:Myocardium / Q000473:pathology*; D054318:No-Reflow Phenomenon / Q000473:pathology; D020257:Ventricular Remodeling / Q000502:physiology
chemical_list: D003287:Contrast Media