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Figure 2 Contrast Short-Axis CMRI and EMB Work Up of Patient #17

(Top row) Contrast short-axis CMRI of Patient #17 (basal slice on the left with subsequent 6-mm slices toward the apex shown to the right; there is a 4-mm gap between slices; TI = 220 ms). For contrast CMRI analysis, each short-axis image was divided into 12 circumferential segments by applying a grid, as demonstrated in the upper row. (Bottom row) Histopathological workup of endomyocardial biopsy (EMB) samples for cardiac amyloidosis included Masson’s trichrome staining with amyloid deposits (arrows) between myocytes (A), Congo red staining (B) with demonstration of typical red/green birefringence (*) under cross-polarized light (C), as well as electron microscopy visualizing amyloid deposits between myocytes expanding the extracellular volume (D and E). LGE = late gadolinium enhancement; other abbreviations as in Figure 1.