The Salvaged Area at Risk in Reperfused Acute Myocardial Infarction as Visualized by Cardiovascular Magnetic Resonance
Matthias G. Friedrich, MD*,*,
Hassan Abdel-Aty, MD*, ,
Andrew Taylor, MD ,
Jeanette Schulz-Menger, MD,
Daniel Messroghli, MD and
Rainer Dietz, MD
* Stephenson Cardiovascular Magnetic Resonance Centre at the Libin Cardiovascular Institute of Alberta, Departments of Cardiac Sciences and Radiology, University of Calgary, Calgary, Alberta, Canada
Franz-Volhard-Klinik, Helios-Klinikum Berlin, Kardiologie, Charité Campus Berlin-Buch, Humboldt-Universität zu Berlin, Berlin, Germany
Baker Heart Research Institute, Melbourne, Australia.
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Figure 1 T2-Weighted CMR Images (Short-Axis View)
(Left) T2-weighted cardiovascular magnetic resonance (CMR) image of a healthy subject with a homogeneous low signal intensity of the myocardium. (Right) T2-weighted CMR image of a patient with an acutely reperfused inferior infarction. The infarct-related injury is visually apparent by a thickened myocardium with high signal (arrows). Apparent extension into the inferior wall of the right ventricle is visible (arrowhead).
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Figure 2 CMR Findings in a Patient With Inferior Myocardial Infarction
(Left) T2-weighted image. There is high signal intensity involving the posterior and the inferior and inferoseptal wall of the left ventricle (arrows) and the right ventricle (arrowhead). (Right) Right coronary angiogram of the same patient before revascularization revealing total occlusion of the right coronary artery. CMR = cardiovascular magnetic resonance.
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Figure 3 Irreversible and Reversible Myocardial Injury in Acute Reperfused Infarcts in 2 Patients as Visually and Semiautomatically Defined
(A) Patient 1. Cardiovascular magnetic resonance (CMR) images 3 days after an acutely reperfused infarct with a subtotal (99%) occlusion of the left anterior descending artery in a 71-year-old patient. (B) Patient 2. CMR images 1 day after reperfusion of an occluded right coronary artery in a 57-year-old patient. Red indicates the result of a semiautomatic delineation of pixels with abnormal signal as defined by a signal intensity of >2 SD above mean signal intensity of the remote myocardium. Note that the spatial extent of myocardial injury in the edema-sensitive T2 imaging is consistently larger than that of the necrosis-sensitive late enhancement.
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