Cardiac MRI Flashcards
main cardiac MRI sequences
SSFP (steady state free precession/white blood), GRE(black blood), Cine
contrast enhanced MRI with delayed enhancement
contrast enhanced CMR protocol
contrast performed pre/post vasodilator stress for hypoperfusion (delayed enhancement)
delayed images to evaluate for scar tissue (infarct, nonischemic etiologies); normal myocardium nulled out
ischemic cardiomyopathy on delayed enhancement
extends from subendocardium to epicardium in vascular distribution
subendocardial delayed enhancement
most susceptible to ischemia
seen after remodeling (chronic infarct)
transmural delayed enhancement
extends across entire myocardial thickness; represents nonviable scar from prior infarct
may also show hypokinesis in the region of abnormal delayed enhancement on cine
nonischemic delayed enhancement
delayed enhancement not in vascular territory; multiple etiologies (DCM, sarcoid, Chagas, HCM, myocarditis, amyloidosis, cardiac transplant)
dilated cardiomyopathy delayed enhancement pattern
most common nonischemic cardiomyopathy (eTOH, myocarditis, drug toxicity)
mid myocardial delayed enhancement; diffuse chamber enlargement, reduced EF
sarcoidosis delayed enhancement pattern
mid myocardial/subepicardial delayed enhancement in nodular/patchy pattern
also, arrhythmia, LV dysfunction, restrictive cardiomyopathy
also look for lung disease and adenopathy
Chagas disease delayed enhancement
epicardial/mid myocardial delayed enhancement, even before symptoms develop
T. cruzi
hypertrophic cardiomyopathy delayed enhancement pattern
abnormal LV myocardial thickening without dilation»_space; sudden death
mid myocardial delayed enhancement in regions of hypertrophied myocardium and at junctions of IV septum and right ventricular free wall due to myofibril disaray
cine: reduced diastolic filling of LV
myocarditis enhancement pattern
epicardial/subepicardial delayed enhancement; wall motion abnormaities in affected regions
autoimmune, viral, drug toxicity
amyloidosis enhancement pattern
circumferential subendocardial delayed enhancement; biventricular myocardial thickening with diffuse ventricular subendocardial delayed enhancement
glycoprotein deposition through extracellular spaces;
cardiac transplant
circumferential subendocardial delayed enhancement
