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Figure 4 Typical Contrast CMRI of 2 Patients Diagnosed With Other Myocardial Diseases

One patient demonstrated focal intramural LGE at the right ventricular insertion points, which is a typical finding in hypertrophic cardiomyopathy (top row, white arrows, TI = 320 ms). This diagnosis was confirmed by histopathology demonstrating myocyte hypertrophy (red cells) and interstitial fibrosis as shown by Masson’s trichrome staining (blue areas between myocytes, black arrows). Note that LGE is also present in the inferior papillary muscle in this patient (thin white arrow). The second patient was diagnosed with myocarditis exhibiting enhanced numbers of interstitial CD68+ macrophages as well as interstitial edema. Molecular pathology revealed PVB19 in the myocardium. The white arrows in the bottom panel point to typical subepicardial LGE in the left ventricular inferolateral wall (TI = 300 ms). Note that the pattern of LGE found in these patients is completely different from the LGE pattern that is usually present in patients with biopsy proven cardiac amyloidosis (Fig. 3). Abbreviations as in Figures 1 and 2.