Skip to main content
SpringerLink
Log in

Late Gadolinium Enhancement Imaging

  • Chapter
Basic Principles of Cardiovascular MRI

  • 2473 Accesses

Abstract

Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) has become a powerful and indispensable tool for the characterization of myocardial fibrosis and scar. LGE images can be acquired using any one of a number of fast T1-weighted gradient echo sequences, approximately 10–20 min post-injection of contrast media. As such, LGE imaging is a simple technique that is an integral part of most clinical CMR protocols. In this chapter, we explore the fundamental principles underpinning the technique, beginning with a discussion of gadolinium contrast kinetics in both normal and damaged myocardium. Next, we describe the underlying basis for LGE imaging: nulling the MRI signal associated with normal myocardium, such that fibrotic or scarred tissue becomes conspicuously bright on T1-weighted images. The chapter continues by providing a brief history of the evolution of LGE pulse sequence development, highlighting many crucial innovations along the way. Finally, we explore a variety of clinical applications of LGE, including its role in the characterization of infarct scar, in multiple cardiomyopathies, and in the rule-out of infectious or infiltrative disease. Common approaches for quantification and characterization of LGE images are also described. While by no means exhaustive, the goal of this chapter is to provide the cardiovascular imager with an understanding of the basic principles of LGE as well as an appreciation for the versatility and clinical utility of the technique.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ratner AV, Okada RD, Newell JB, Pohos GM. The relationship between proton nuclear magnetic resonance relaxation parameters and myocardial perfusion with acute coronary arterial occlusion and reperfusion. Circulation. 1985;71(4):823–8.

    Article  CAS  PubMed  Google Scholar 

  2. Wesbey G, Higgins CB, Lanzer P, Botvinick E, Lipton MJ. Imaging and characterization of acute myocardial infarction in vivo by gated nuclear magnetic resonance. Circulation. 1984;69:125–30.

    Article  CAS  PubMed  Google Scholar 

  3. McNamara MT, Higgins CB, Ehman RL, Revel D, Sievers R, Brasch RC. Acute myocardial ischemia: magnetic resonance contrast enhancement with gadolinium-DTPA. Radiology. 1984;153:157–63.

    Article  CAS  PubMed  Google Scholar 

  4. Johnston DL, Brady TJ, Ratner AV, Rosen BR, Newell JB, Pohost GM, Okada RD. Assessment of myocardial ischemia with proton magnetic resonance: effects of a three hour coronary occlusion with and without reperfusion. Circulation. 1985;71(3):595–601.

    Article  CAS  PubMed  Google Scholar 

  5. Pflugfelder PW, Wisenberg G, Prato FS, Carroll SE, Turner KL. Early detection of canine myocardial infarction by magnetic resonance imaging in vivo. Circulation. 1985;71(3):587–94.

    Article  CAS  PubMed  Google Scholar 

  6. Bouchard A, Reeves RC, Cranney G, Bishop SP, Pohost GM. Assessment of myocardial infarct size by means of T2-weighted 1H nuclear magnetic resonance imaging. Am Heart J. 1989;117:281–9.

    Article  CAS  PubMed  Google Scholar 

  7. Ryan T, Tarver RD, Duerk JL, Sawada SG, Hollenkamp NC. Distinguishing viable from infarcted myocardium after experimental ischemia and reperfusion by using nuclear magnetic resonance imaging. J Am Coll Cardiol. 1990;15:1355–64.

    Article  CAS  PubMed  Google Scholar 

  8. Wesbey G, Weinmann HJ, Brasch RC, Press WR. Characteristics of gadolinium-DTPA complex: a potential NMR contrast agent. AJR Am J Roentgenol. 1984;142:619–24.

    Article  PubMed  Google Scholar 

  9. Prato FS, Wisenberg G, Marshall TP, Uksik P, Zabel P. Comparison of the biodistribution of gadolinium-153 DTPA and technetium-99m DTPA in rats. J Nucl Med. 1988;29:1683–7.

    CAS  PubMed  Google Scholar 

  10. Judd JR, Kim RJ, Chen EL, Lima JA. Myocardial Gd-DTPA kinetics determine MRI contrast enhancement and reflect the extent and severity of myocardial injury after acute reperfused infarction. Circulation. 1996;94(12):3318–26.

    Article  PubMed  Google Scholar 

  11. Diesbourg LD, Prato FS, Wisenberg G, Drost DJ, Marshall TP, Carroll SE, O’Neill B. Quantification of myocardial blood flow and extracellular volumes using a bolus injection of Gd-DTPA: kinetic modeling in canine ischemic disease. Magn Reson Med. 1992;23(2):239–53.

    Article  CAS  PubMed  Google Scholar 

  12. Tong CY, Prato FS, Wisenberg G, Lee TY, Carroll E, Sandler D, Wills J. Techniques for the measurement of the local myocardial extraction efficiency for inert diffusible contrast agents such as gadopentate dimeglumine. Magn Reson Med. 1993;30(14):332–6.

    Article  CAS  PubMed  Google Scholar 

  13. Pereira RS, Prato FS, Sykes J, Wisenberg G. Assessment of myocardial viability using MRI during a constant infusion of Gd-DTPA: further studies at early and late periods of reperfusion. Magn Reson Med. 1999;42(1):60–8.

    Article  CAS  PubMed  Google Scholar 

  14. Pereira RS, Prato FS, Wisenberg G, Sykes J. The determination of myocardial viability using Gd-DTPA in a canine model of acute myocardial ischemia and reperfusion. Magn Reson Med. 1996;36:684–93.

    Article  CAS  PubMed  Google Scholar 

  15. Pereira RS, Prato FS, Lekx KS, Sykes J, Wisenberg G. Contrast-enhanced MRI for the assessment of myocardial viability after permanent coronary artery occlusion. Magn Reson Med. 2000;44(2):309–16.

    Article  CAS  PubMed  Google Scholar 

  16. Pereira RS, Wisenberg G, Prato FS, Yvorchuk K. Clinical assessment of myocardial viability using MRI during a constant infusion of Gd-DTPA. MAGMA. 2000;11(3):104–13.

    Article  CAS  PubMed  Google Scholar 

  17. Flacke SJ, Fischer SE, Lorenz CH. Measurement of the gadopentetate dimeglumine partition coefficient in human myocardium in vivo: normal distribution and elevation in acute and chronic infarction. Radiology. 2001;218:703–10.

    Article  CAS  PubMed  Google Scholar 

  18. Choi KM, Kim RJ, Gubernikoff G, Vargas JD, Parker M, Judd RM. Transmural extent of acute myocardial infarction predicts long-term improvement in contractile function. Circulation. 2001;104:1101–7.

    Article  CAS  PubMed  Google Scholar 

  19. Ricciardi MJ, Wu E, Davidson CJ, Choi KM, Klocke FJ, Bonow RO, Judd RM, Kim RJ. Visualization of discrete microinfarction after percutaneous coronary intervention associated with mild creatine kinase-MB elevation. Circulation. 2001;103(23):2780–3.

    Article  CAS  PubMed  Google Scholar 

  20. Wagner A, Mahrholdt H, Holly TA, Elliott MD, Regenfus M, Parker M, Klocke FJ, Bonow RO, Kim RJ, Judd RM. Contrast-enhanced MRI and routine single photon emission computed tomography (SPECT) perfusion imaging for detection of subendocardial myocardial infarcts: an imaging study. Lancet. 2003;361(9355):374–9.

    Article  PubMed  Google Scholar 

  21. Wu E, Judd RM, Vargas JD, Klocke FJ, Bonow RO, Kim RJ. Visualisation of presence, location, and transmural extent of healed Q-wave and non-Q-wave myocardial infarction. Lancet. 2001;357(9249):21–8.

    Article  CAS  PubMed  Google Scholar 

  22. Kim RJ, Shah DJ, Judd RM. How we perform delayed enhancement imaging. J Cardiovasc Magn Reson Off J Soc Cardiovasc Magn Reson. 2003;5:505–14.

    Google Scholar 

  23. Simonetti O, Chung YC, Lee VS, Laub G. Inversion recovery cine trueFISP for optimizing TI in myocardial infarct imaging. Proc Intl Soc Mag Reson Med. 2002;10:2019.

    Google Scholar 

  24. Tong CY, Prato FS, Wisenberg G, Lee TY, Carroll E, Sandler D, Wills J, Drost D. Measurement of the extraction efficiency and distribution volume for Gd-DTPA in normal and diseased canine myocardium. Magn Reson Med. 1993;30(3):337–46.

    Article  CAS  PubMed  Google Scholar 

  25. Kim RJ, Fieno DS, Parrish TB, Harris K, Chen E, Simonetti O, Bundy J, Finn JP, Klocke FJ, Judd RM. Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. Circulation. 1999;100:1992–2002.

    Article  CAS  PubMed  Google Scholar 

  26. Rogers WJ, Kramer CM, Geskin G, Hu YL, Theobald TM, Vido DA, Petruolo S, Reichek N. Early contrast-enhanced MRI predicts late functional recovery after reperfused myocardial infarction. Circulation. 1999;99(6):744–50.

    Article  PubMed  Google Scholar 

  27. Judd RM, Reeder SB, Atalar E, McVeigh ER, Zerhouni EA. A magnetization-driven gradient echo pulse sequence for the study of myocardial perfusion. Magn Reson Med. 1995;34:276–82.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Simonetti OP, Kim RJ, Fieno DS, Hillenbrand HB, Wu E, Bundy JM, Finn JP, Judd RM. An improved MR imaging technique for the visualization of myocardial infarction. Radiology. 2001;218(9):215–23.

    Article  CAS  PubMed  Google Scholar 

  29. Judd R, Kim RJ, Wu E, Rafael A, Chen EL, Parker MA, Simonetti O, Klocke FJ, Bonow RO. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med. 2000;343(20):1445–53.

    Article  PubMed  Google Scholar 

  30. Kim D, Lee VS, Srichai MB. Improved visualization of non-transmural scar using slice-selective inversion-recovery delayed contrast-enhanced MRI : a preliminary report. NMR Biomed. 2007;20:121–7.

    Article  PubMed  Google Scholar 

  31. Kellman P, Arai AE, McVeigh ER, Aletras AH. Phase-sensitive inversion recovery for detecting myocardial infarction using gadolinium-delayed hyperenhancement. Magn Reson Med. 2002;47:372–83.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Huber AM, Schoenberg SO, Hayes C, Spannagl B, Engelmann MG, Franz WM, Reiser MF. Phase-sensitive inversion-recovery MR imaging in the detection of myocardial infarction. Radiology. 2005;237:854–60.

    Article  PubMed  Google Scholar 

  33. Kühl HP, Papavasiliu TS, Beek AM, Hofman MBM, Heusen NS, van Rossum AC. Myocardial viability: rapid assessment with delayed contrast-enhanced MR imaging with three-dimensional inversion-recovery prepared pulse sequence. Radiology. 2004;230(2):576–82.

    Article  PubMed  Google Scholar 

  34. Bauner KU, Muehling O, Theisen D, Hayes C, Wintersperger BJ, Reiser MF, Huber AM. Assessment of myocardial viability with 3D MRI at 3 T. AJR Am J Roentgenol. 2009;192(6):1645–50.

    Article  PubMed  Google Scholar 

  35. Saranathan M, Rochitte CE, Foo TKF. Fast, three-dimensional free-breathing MR imaging of myocardial infarction: a feasibility study. Magn Reson Med. 2004;51(5):1055–60.

    Article  PubMed  Google Scholar 

  36. Ehman RL, Felmlee JP. Adaptive technique for high-definition MR imaging of moving structures. Radiology. 1989;173:255–63.

    Article  CAS  PubMed  Google Scholar 

  37. Wendland M, Arheden H, Saeed M, Higgins CB, Gao DW, Bremerich J, Wyttenbach R, Dae MW. Measurement of the gadopentetate dimeglumine at echo-planar MR imaging to quantify myocardial infarction : comparison with 99m Tc-DTPA autoradiography in rats. Radiology. 1999;211:698–708.

    Article  PubMed  Google Scholar 

  38. Wendland M, Arheden H, Saeed M, Higgins CB, Gao DW, Ursell PC, Bremerich J, Wyttenbach R, Dae MW. Reperfused rat myocardium subjected to various durations of ischemia: estimation of the distribution volume of contrast material with echo-planar MR imaging. Radiology. 2000;215:520–8.

    Article  PubMed  Google Scholar 

  39. Wendland MF, Saeed M, Lauerma K, Derugin N, Mintorovitch J, Cavagna FM, Higgins CB. Alterations in T1 of normal and reperfused infarcted myocardium after Gd-BOPTA versus GD-DTPA on inversion recovery EPI. Magn Reson Med. 1997;37:448–56.

    Article  CAS  PubMed  Google Scholar 

  40. Higgins C, Saeed M, Lund G, Wendland MF, Bremerich J, Weinmann H. Magnetic resonance characterization of the peri-infarction zone of reperfused myocardial infarction with necrosis-specific and extracellular contrast media. Circulation. 2001;103:871–6.

    Article  PubMed  Google Scholar 

  41. Oshinski JN, Yang Z, Jones JR, Mata JF, French BA. Imaging time after Gd-DTPA injection is critical in using delayed enhancement to determine infarct size accurately with magnetic resonance imaging. Circulation. 2001;104(23):2838–42.

    Article  CAS  PubMed  Google Scholar 

  42. Inoue S, Murakami Y, Ochiai K, Kitamura J, Ishibashi Y, Kawamitsu H, Sugimura K, Shimada T. The contributory role of interstitial water in Gd-DTPA-enhanced MRI in myocardial infarction. J Magn Reson Imaging. 1999;9(2):215–9.

    Article  CAS  PubMed  Google Scholar 

  43. Judd RM, Lugo-Olivieri CH, Arai M, Kondo T, Croisille P, Lima JA, Mohan V, Becker LC, Zerhouni EA. Physiological basis of myocardial contrast enhancement in fast magnetic resonance images of 2-day-old reperfused canine infarcts. Circulation. 1995;92:1902–10.

    Article  CAS  PubMed  Google Scholar 

  44. Wu KC, Kim RJ, Bluemke DA, Rochitte CE, Zerhouni EA, Becker LC, Lima JA. Quantification and time course of microvascular obstruction by contrast-enhanced echocardiography and magnetic resonance imaging following acute myocardial infarction and reperfusion. J Am Coll Cardiol. 1998;32(6):1756–64.

    Article  CAS  PubMed  Google Scholar 

  45. Gerber BL, Rochitte CE, Bluemke DA, Melin JA, Crosille P, Becker LC, Lima JA. Relation between Gd-DTPA contrast enhancement and regional inotropic response in the periphery and center of myocardial infarction. Circulation. 2001;104(9):998–1004.

    Article  CAS  PubMed  Google Scholar 

  46. Hillenbrand HB, Kim RJ, Parker MA, Fieno DS, Judd RM. Early assessment of myocardial salvage by contrast-enhanced magnetic resonance imaging. Circulation. 2000;102(14):1678–83.

    Article  CAS  PubMed  Google Scholar 

  47. Fieno DS, Kim RJ, Chen E, Lomasney JW, Klocke FJ, Judd RM. Contrast-enhanced magnetic resonance imaging of myocardium at risk: distinction between reversible and irreversible injury throughout infarct healing. J Am Coll Cardiol. 2000;36(3):1985–91.

    Article  CAS  PubMed  Google Scholar 

  48. Dendale P, Franken PR, Block P, Pratikakis Y, De Roos A. Contrast enhanced and functional magnetic resonance imaging for the detection of viable myocardium after infarction. Am Heart J. 1998;135:875–80.

    Article  CAS  PubMed  Google Scholar 

  49. Ramani K, Judd RM, Holly TA, Parrish TB, Rigolin VH, Parker MA, Callahan C, Fitzgerald SW, Bonow RO, Klocke FJ. Contrast magnetic resonance imaging in the assessment of myocardial viability in patients with stable coronary artery disease and left ventricular dysfunction. Circulation. 1998;98(24):2687–94.

    Article  CAS  PubMed  Google Scholar 

  50. Lauerma K, Niemi P, Janatuinen T, Knuuti J, Toivonen L, Aronen HJ. Multimodality MR imaging assessment of myocardial viability: combination of first-pass and late contrast enhancement to wall motion dynamics and comparison with FDG PET—initial experience. Radiology. 2000;217(5):729–36.

    Article  CAS  PubMed  Google Scholar 

  51. Klein C, Nekolla SG, Bengel FM, Momose M, Sammer A, Haas F, Schnackenburg B, Delius W, Mudra H, Wolfram D, Schwaiger M. Assessment of myocardial viability with contrast-enhanced magnetic resonance imaging: comparison with positron emission tomography. Circulation. 2002;105(2):162–7.

    Article  PubMed  Google Scholar 

  52. van Voorthuisen A, de Roos A, Doornbos J, van der Wall EE. MR imaging of acute myocardial infarction: value of Gd-DTPA. AJR Am J Roentgenol. 1988;150:531–4.

    Article  PubMed  Google Scholar 

  53. Judd RM, Kim RJ. Imaging time after Gd-DTPA injection is critical in using delayed enhancement to determine infarct size accurately with magnetic resonance imaging. Circulation. 2002;106(2):e6. p. e6; author reply e6, Jul.

    Article  PubMed  Google Scholar 

  54. Lekx K, Prato F, Sykes J, Wisenberg G. The partition coefficient of Gd‐DTPA reflects maintained tissue viability in a canine model of chronic significant coronary stenosis. J Cardiovasc Magn Reson. 2004;6(1):33–42.

    Article  PubMed  Google Scholar 

  55. Rehwald WG, Fieno DS, Chen E-L, Kim RJ, Judd RM. Myocardial magnetic resonance imaging contrast agent concentrations after reversible and irreversible ischemic injury. Circulation. 2002;105(2):224–9.

    Article  PubMed  Google Scholar 

  56. Thornhill RE, Prato FS, Pereira RS, Wisenberg G, Sykes J. Examining a canine model of stunned myocardium with Gd-DTPA-enhanced MRI. Magn Reson Med. 2001;45(5):864–71.

    Article  CAS  PubMed  Google Scholar 

  57. Sun Y, Weber KT. Infarct scar: a dynamic tissue. Cardiovasc Res. 2000;46(2):250–6.

    Article  CAS  PubMed  Google Scholar 

  58. Thornhill RE, Prato FS, Wisenberg G. The assessment of myocardial viability: a review of current diagnostic imaging approaches. J Cardiovasc Magn Reson. 2002;4(3):381–410.

    Article  PubMed  Google Scholar 

  59. White JA, Patel MR. The role of cardiovascular MRI in heart failure and the cardiomyopathies. Cardiol Clin. 2007;25(1):71–95. vi.

    Article  PubMed  Google Scholar 

  60. Allman KC, Shaw LJ, Hachamovitch R, Udelson JE. Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: a meta-analysis. J Am Coll Cardiol. 2002;39:1151–8.

    Article  PubMed  Google Scholar 

  61. Kubo N, Morimoto S, Hiramitsu S, Uemura A, Kimura K, Shimizu K, Hishida H. Feasibility of diagnosing chronic myocarditis by endomyocardial biopsy. Hear Vessel. 1997;12:167–70.

    Google Scholar 

  62. McCrohon JA, Moon JCC, Prasad SK, McKenna WJ, Lorenz CH, Coats AJS, Pennell DJ. Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium-enhanced cardiovascular magnetic resonance. Circulation. 2003;108(1):54–9.

    Article  CAS  PubMed  Google Scholar 

  63. Gulati A, et al. Association of fibrosis with mortality and sudden cardiac death in patients with nonischemic dilated cardiomyopathy. JAMA. 2013;309(9):896–908. PMID 23462786.

    Article  CAS  PubMed  Google Scholar 

  64. Libby P. Braunwald’s heart disease: a textbook of cardiovascular medicine. 8th ed. Philadelphia: Saunders Company; 2007.

    Google Scholar 

  65. Chun EJ, Il Choi S, Jin KN, Kwag HJ, Kim YJ, Choi BW, Lee W, Park JH. Hypertrophic cardiomyopathy: assessment with MR imaging and multidetector CT. Radiogr Rev Publ Radiol Soc N Am Inc. 2010;30:1309–28.

    Google Scholar 

  66. Wilson JM, et al. Imaging of myocardial fibrosis in hypertrophic. Texas Heart Inst J. 2002;29(3):176–80.

    Google Scholar 

  67. Teraoka K, Hirano M, Ookubo H, Sasaki K, Katsuyama H, Amino M, Abe Y, Yamashina A. Delayed contrast enhancement of MRI in hypertrophic cardiomyopathy. Magn Reson Imaging. 2004;22(2):155–61.

    Article  PubMed  Google Scholar 

  68. Rubinshtein R, Glockner JF, Ommen SR, Araoz PA, Ackerman MJ, Sorajja P, Bos JM, Tajik AJ, Valeti US, Nishimura RA, Gersh BJ. Characteristics and clinical significance of late gadolinium enhancement by contrast-enhanced magnetic resonance imaging in patients with hypertrophic cardiomyopathy. Circ Heart Fail. 2010;3(1):51–8.

    Article  PubMed  Google Scholar 

  69. Kim RJ, Judd RM. Gadolinium-enhanced magnetic resonance imaging in hypertrophic cardiomyopathy. J Am Coll Cardiol. 2003;41(9):1568–72.

    Article  PubMed  Google Scholar 

  70. Maron MS, Maron BJ, Harrigan C, Buros J, Gibson CM, Olivotto I, Biller L, Lesser JR, Udelson JE, Manning WJ, Appelbaum E. Hypertrophic cardiomyopathy phenotype revisited after 50 years with cardiovascular magnetic resonance. J Am Coll Cardiol. 2009;54(3):220–8.

    Article  PubMed  Google Scholar 

  71. Choudhury L, Mahrholdt H, Wagner A, Choi KM, Elliott MD, Klocke FJ, Bonow RO, Judd RM, Kim RJ. Myocardial scarring in asymptomatic or mildly symptomatic patients with hypertrophic cardiomyopathy. J Am Coll Cardiol. 2002;40(12):2156–64.

    Article  PubMed  Google Scholar 

  72. Moon JC, McKenna WJ, McCrohon JA, Elliott PM, Smith GC, Pennell DJ. Toward clinical risk assessment in hypertrophic cardiomyopathy with gadolinium cardiovascular magnetic resonance. J Am Coll Cardiol. 2003;41(9):1561–7.

    Article  PubMed  Google Scholar 

  73. O’Hanlon R, Grasso A, Roughton M, Moon JC, Clark S, Wage R, Webb J, Kulkarni M, Dawson D, Sulaibeekh L, Chandrasekaran B, Bucciarelli-Ducci C, Pasquale F, Cowie MR, McKenna WJ, Sheppard MN, Elliott PM, Pennell DJ, Prasad SK. Prognostic significance of myocardial fibrosis in hypertrophic cardiomyopathy. J Am Coll Cardiol. 2010;56:431–4.

    Google Scholar 

  74. Adabag AS, Maron BJ, Appelbaum E, Harrigan CJ, Buros JL, Gibson CM, Lesser JR, Hanna CA, Udelson JE, Manning WJ, Maron MS. Occurrence and frequency of arrhythmias in hypertrophic cardiomyopathy in relation to delayed enhancement on cardiovascular magnetic resonance. J Am Coll Cardiol. 2008;51(14):1369–74.

    Article  PubMed  Google Scholar 

  75. Kwon DH, Setser RM, Popović ZB, Thamilarasan M, Sola S, Schoenhagen P, Garcia MJ, Flamm SD, Lever HM, Desai MY. Association of myocardial fibrosis, electrocardiography and ventricular tachyarrhythmia in hypertrophic cardiomyopathy: a delayed contrast enhanced MRI study. Int J Cardiovasc Imaging. 2008;24(6):617–25.

    Article  PubMed  Google Scholar 

  76. Leonardi S, Raineri C, De Ferrari GM, Ghio S, Scelsi L, Pasotti M, Tagliani M, Valentini A, Dore R, Raisaro A, Arbustini E. Usefulness of cardiac magnetic resonance in assessing the risk of ventricular arrhythmias and sudden death in patients with hypertrophic cardiomyopathy. Eur Heart J. 2009;30(16):2003–10.

    Article  PubMed  Google Scholar 

  77. Sen-Chowdhry S, Syrris P, Ward D, Asimaki A, Sevdalis E, McKenna WJ. Clinical and genetic characterization of families with arrhythmogenic right ventricular dysplasia/cardiomyopathy provides novel insights into patterns of disease expression. Circulation. 2007;115:1710–20.

    Article  PubMed  Google Scholar 

  78. Shimada T, Shimada K, Sakane T, Ochiai K, Tsukihashi H, Fukui M, Inoue S, Katoh H, Murakami Y, Ishibashi Y, Maruyama R. Diagnosis of cardiac sarcoidosis and evaluation of the effects of steroid therapy by gadolinium-DTPA-enhanced magnetic resonance imaging. Am J Med. 2001;110:520–7.

    Article  CAS  PubMed  Google Scholar 

  79. Marcus FI, McKenna WJ, Sherrill D, Basso C, Bauce B, Bluemke DA, Calkins H, Corrado D, Cox MGPJ, Daubert JP, Fontaine G, Gear K, Hauer R, Nava A, Picard MH, Protonotarios N, Saffitz JE, Sanborn DMY, Steinberg JS, Tandri H, Thiene G, Towbin JA, Tsatsopoulou A, Wichter T, Zareba W. Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the Task Force Criteria. Eur Heart J. 2010;31:806–14.

    Article  PubMed Central  PubMed  Google Scholar 

  80. Steckman DA, Schneider PM, Schuller JL, Aleong RG, Nguyen DT, Sinagra G, Vitrella G, Brun F, Cova MA, Pagnan L, Mestroni L, Varosy PD, Sauer WH. Utility of cardiac magnetic resonance imaging to differentiate cardiac sarcoidosis from arrhythmogenic right ventricular cardiomyopathy. Am J Cardiol. 2012;110(4):575–9.

    Article  PubMed  Google Scholar 

  81. Ayyala US, Nair AP, Padilla ML. Cardiac sarcoidosis. Clin Chest Med. 2008;29:493–508. ix.

    Article  PubMed  Google Scholar 

  82. Silverman KJ, Hutchins GM, Bulkley BH. Cardiac sarcoid: a clinicopathologic study of 84 unselected patients with systemic sarcoidosis. Circulation. 1978;58:1204–11.

    Article  CAS  PubMed  Google Scholar 

  83. Roberts WC, McAllister HA, Ferrans VJ. Sarcoidosis of the heart. A clinicopathologic study of 35 necropsy patients (group 1) and review of 78 previously described necropsy patients (group 11). Am J Med. 1977;63:86–108.

    Article  CAS  PubMed  Google Scholar 

  84. Smedema J-P, Snoep G, van Kroonenburgh MPG, van Geuns R-J, Dassen WRM, Gorgels APM, Crijns HJGM. Evaluation of the accuracy of gadolinium-enhanced cardiovascular magnetic resonance in the diagnosis of cardiac sarcoidosis. J Am Coll Cardiol. 2005;45(10):1683–90.

    Article  PubMed  Google Scholar 

  85. Wu Y-W, Tadamura E, Kanao S, Yamamuro M, Marui A, Komeda M, Toma M, Kimura T, Togashi K. Myocardial viability by contrast-enhanced cardiovascular magnetic resonance in patients with coronary artery disease: comparison with gated single-photon emission tomography and FDG position emission tomography. Int J Cardiovasc Imaging. 2007;23(6):757–65.

    Article  CAS  PubMed  Google Scholar 

  86. Ichinose A, Otani H, Oikawa M, Takase K, Saito H, Shimokawa H, Takahashi S. MRI of cardiac sarcoidosis: basal and subepicardial localization of myocardial lesions and their effect on left ventricular function. AJR Am J Roentgenol. 2008;191:862–9.

    Article  PubMed  Google Scholar 

  87. Patel MR, Cawley PJ, Heitner JF, Klem I, Parker MA, Jaroudi WA, Meine TJ, White JB, Elliott MD, Kim HW, Judd RM, Kim RJ. Detection of myocardial damage in patients with sarcoidosis. Circulation. 2009;120:1969.

    Article  PubMed Central  PubMed  Google Scholar 

  88. Hiroe M, Hiraga H, Yuwai K. Guideline for diagnosis of cardiac sarcoidosis: study report on diffuse pulmonary disease from the Japanese Ministry of Health and Welfare. Tokyo: Japanese Ministry of Health and Welfare; 1993. p. 23–4.

    Google Scholar 

  89. Angelini A, Calzolari V, Calabrese F, Boffa GM, Maddalena F, Chioin R, Thiene G. Myocarditis mimicking acute myocardial infarction: role of endomyocardial biopsy in the differential diagnosis. Heart. 2000;84:245–50.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  90. Mahrholdt H, Goedecke C, Wagner A, Meinhardt G, Athanasiadis A, Vogelsberg H, Fritz P, Klingel K, Kandolf R, Sechtem U. Cardiovascular magnetic resonance assessment of human myocarditis: a comparison to histology and molecular pathology. Circulation. 2004;109(10):1250–8.

    Article  PubMed  Google Scholar 

  91. Friedrich MG, Strohm O, Schulz-Menger J, Marciniak H, Luft FC, Dietz R. Contrast media-enhanced magnetic resonance imaging visualizes myocardial changes in the course of viral myocarditis. Circulation. 1998;97:1802–9.

    Article  CAS  PubMed  Google Scholar 

  92. Shah KB, Inoue Y, Mehra MR. Amyloidosis and the heart: a comprehensive review. Arch Intern Med. 2006;166:1805–13.

    Article  CAS  PubMed  Google Scholar 

  93. Duston MA, Skinner M, Shirahama T, Cohen AS. Diagnosis of amyloidosis by abdominal fat aspiration. Analysis of four years’ experience. Am J Med. 1987;82:412–4.

    Article  CAS  PubMed  Google Scholar 

  94. Maceira AM, Joshi J, Prasad SK, Moon JC, Perugini E, Harding I, Sheppard MN, Poole-Wilson PA, Hawkins PN, Pennell DJ. Cardiovascular magnetic resonance in cardiac amyloidosis. Circulation. 2005;111(2):186–93.

    Article  PubMed  Google Scholar 

  95. Vogelsberg H, Mahrholdt H, Deluigi CC, Yilmaz A, Kispert EM, Greulich S, Klingel K, Kandolf R, Sechtem U. Cardiovascular magnetic resonance in clinically suspected cardiac amyloidosis: noninvasive imaging compared to endomyocardial biopsy. J Am Coll Cardiol. 2008;51:1022–30.

    Article  PubMed  Google Scholar 

  96. Syed IS, Glockner JF, Feng D, Araoz PA, Martinez MW, Edwards WD, Gertz MA, Dispenzieri A, Oh JK, Bellavia D, Tajik AJ, Grogan M. Role of cardiac magnetic resonance imaging in the detection of cardiac amyloidosis. JACC Cardiovasc Imaging. 2010;3:155–64.

    Article  PubMed  Google Scholar 

  97. Perugini E, Rapezzi C, Piva T, Leone O, Bacchi-Reggiani L, Riva L, Salvi F, Lovato L, Branzi A, Fattori R. Non-invasive evaluation of the myocardial substrate of cardiac amyloidosis by gadolinium cardiac magnetic resonance. Heart. 2006;92:343–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  98. Srichai MB, Junor C, Rodriguez LL, Stillman AE, Grimm RA, Lieber ML, Weaver JA, Smedira NG, White RD. Clinical, imaging, and pathological characteristics of left ventricular thrombus: a comparison of contrast-enhanced magnetic resonance imaging, transthoracic echocardiography, and transesophageal echocardiography with surgical or pathological validation. Am Heart J. 2006;152:75–84.

    Article  PubMed  Google Scholar 

  99. Weinsaft JW, Kim HW, Shah DJ, Klem I, Crowley AL, Brosnan R, James OG, Patel MR, Heitner J, Parker M, Velazquez EJ, Steenbergen C, Judd RM, Kim RJ. Detection of left ventricular thrombus by delayed-enhancement cardiovascular magnetic resonance prevalence and markers in patients with systolic dysfunction. J Am Coll Cardiol. 2008;52:148–57.

    Article  PubMed  Google Scholar 

  100. Peters DC, Wylie JV, Hauser TH, Kissinger KV, Josephson ME, Manning WJ. Detection of pulmonary vein and left atrial scar after catheter ablation with three-dimensional navigator-gated delayed enhancement MR imaging: methods: results: conclusion. Radiology. 2007;243(3):690–5.

    Article  PubMed  Google Scholar 

  101. Oakes RS, Badger TJ, Kholmovski EG, Akoum N, Burgon NS, Fish EN, Blauer JJE, Rao SN, DiBella EVR, Segerson NM, Daccarett M, Windfelder J, McGann CJ, Parker D, MacLeod RS, Marrouche NF. Detection and quantification of left atrial structural remodeling with delayed-enhancement magnetic resonance imaging in patients with atrial fibrillation. Circulation. 2009;119(13):1758–67.

    Article  PubMed Central  PubMed  Google Scholar 

  102. Kramer CM, Barkhausen J, Flamm SD, Kim RJ, Nagel E. Standardized cardiovascular magnetic resonance imaging (CMR) protocols, society for cardiovascular magnetic resonance: board of trustees task force on standardized protocols. J Cardiovasc Magn Reson. 2008;10:1–10.

    Article  Google Scholar 

  103. Amado LC, Gerber BL, Gupta SN, Rettmann DW, Szarf G, Schock R, Nasir K, Kraitchman DL, Lima JC. Accurate and objective infarct sizing by contrast-enhanced magnetic resonance imaging in a canine myocardial infarction model. J Am Coll Cardiol. 2004;44(12):2383–9.

    Article  PubMed  Google Scholar 

  104. Flett AS, Hasleton J, Cook C, Hausenloy D, Quarta G, Ariti C, Muthurangu V, Moon JC. Evaluation of techniques for the quantification of myocardial scar of differing etiology using cardiac magnetic resonance. JACC Cardiovasc Imaging. 2011;4(2):150–6.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, University of Ottawa, Ottawa, ON, Canada

    Rebecca E. Thornhill PhD & Elena Peña MD

  2. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada

    Rebecca E. Thornhill PhD

  3. Department Medical Imaging c/o Laura Lang, The Ottawa Hospital, Civic Campus, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada

    Rebecca E. Thornhill PhD

  4. Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada

    Elena Peña MD

Authors
  1. Rebecca E. Thornhill PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elena Peña MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rebecca E. Thornhill PhD .

Editor information

Editors and Affiliations

  1. Department of Medicine, Loyola University Medical Center, Maywood, Illinois, USA

    Mushabbar A. Syed

  2. The Ohio State University, Columbus, Ohio, USA

    Subha V. Raman

  3. The Ohio State University, Columbus, Ohio, USA

    Orlando P. Simonetti

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Thornhill, R.E., Peña, E. (2015). Late Gadolinium Enhancement Imaging. In: Syed, M., Raman, S., Simonetti, O. (eds) Basic Principles of Cardiovascular MRI. Springer, Cham. https://doi.org/10.1007/978-3-319-22141-0_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-22141-0_15

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22140-3

  • Online ISBN: 978-3-319-22141-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation