Cardiovascular magnetic resonance imaging (CMR) with delayed contrast enhancement
(DCE) using Gadolinium based contrast media is a recently developed technique which
allows the direct visualisation of myocardial necrosis or fibrosis as regions of bright
signal (hyperenhancement) compared with normal myocardium. The manuscript presents
a review of the current clinical application of DCE–CMR for the diagnosis and prognosis
of various common cardiac conditions such as ischaemic and non-ischaemic cardiomyopathies,
and less common diseases such as cardiac sarcoidosis or Löffler endocarditis (Table
1).
Keywords
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References
- An improved MR imaging technique for the visualization of myocardial infarction.Radiology. 2001; 218: 215-223
- Clinical indications for cardiovascular magnetic resonance (CMR): Consensus Panel report.Eur Heart J. 2004; 25: 1940-1965
- Characteristics of gadolinium-DTPA complex: a potential NMR contrast agent.Am J Roentgenol. 1984; 142: 619-624
- Regional heterogeneity of human myocardial infarcts demonstrated by contrast-enhanced MRI. Potential mechanisms.Circulation. 1995; 92: 1117-1125
- How we perform delayed enhancement imaging.J Cardiovasc Magn Reson. 2003; 5: 505-514
- The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction.N Engl J Med. 2000; 343: 1445-1453
- Magnetic resonance imaging for the assessment of myocardial viability.J Magn Reson Imaging. 2004; 19: 771-788
Heart disease and stroke statistics—2006 update: a report from the American Heart Association statistics committee and stroke statistics subcommittee. Circulation 2006;113:85–151.
- Predictors of clinical course, coronary anatomy and left ventricular function after recovery from acute myocardial infarction.Circulation. 1980; 62: 960-970
- Survival of medically treated patients in the coronary artery surgery study (CASS) registry.Circulation. 1982; 66: 562-568
- Determinants of improved left ventricular function after thrombolytic therapy in acute myocardial infarction.J Am Coll Cardiol. 1987; 9: 937-944
- Segmental wall motion abnormalities in the absence of clinically documented myocardial infarction: clinical significance and evidence of hibernating myocardium.Am Heart J. 1991; 121: 1088-1094
- Regional myocardial functional and electrophysiological alterations after brief coronary artery occlusion in conscious dogs.J Clin Invest. 1975; 56: 978-985
- The hibernating myocardium.Am Heart J. 1989; 117: 211-221
- Myocardial viability—what is the definition?.J Nucl Med. 1991; 32: 10-12
- Value of metabolic imaging with positron emission tomography for evaluating prognosis in patients with coronary artery disease and left ventricular dysfunction.Am J Cardiol. 1994; 73: 527-533
- Clinical outcome of patients with advanced coronary artery disease after viability studies with positron emission tomography.J Am Coll Cardiol. 1992; 20: 559-565
- Prediction by postexercise fluoro-18 deoxyglucose positron emission tomography of improvement in exercise capacity after revascularization.Am J Cardiol. 1992; 69: 854-859
- 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: 1151-1158
- Myocardial Gd-DTPA kinetics determine MRI contrast enhancement and reflect the extent and severity of myocardial injury after acute reperfused infarction.Circulation. 1996; 94: 3318-3326
- Differentiation of reversible and irreversible myocardial injury by MR imaging with and without gadolinium-DTPA.Radiology. 1986; 158: 765-769
- Physiological basis of myocardial contrast enhancement in fast magnetic resonance images of 2-day-old reperfused canine infarcts.Circulation. 1995; 92: 1902-1910
- Magnitude and time course of microvascular obstruction and tissue injury after acute myocardial infarction.Circulation. 1998; 98: 1006-1014
- Magnetic resonance characterization of the peri-infarct zone of reperfused myocardial infarction with necrosis-specific and extracellular nonspecific contrast media.Circulation. 2001; 103: 871-876
- Gadolinium delayed enhancement cardiovascular magnetic resonance correlates with clinical measures of myocardial infarction.J Am Coll Cardiol. 2004; 43: 2253-2599
- Prognostic significance of microvascular obstruction by magnetic resonance imaging in patients with acute myocardial infarction.Circulation. 1998; 97: 765-772
- Imaging techniques for the assessment of myocardial hibernation. Report of a Study Group of the European Society of Cardiology.Eur Heart J. 2004; 25: 815-836
- Accuracy of contrast-enhanced magnetic resonance imaging in predicting improvement of regional myocardial function in patients after acute myocardial infarction.Circulation. 2002; 106: 1083-1089
- Delayed contrast-enhanced magnetic resonance imaging for the prediction of regional functional improvement after acute myocardial infarction.J Am Coll Cardiol. 2003; 42: 895-901
- Value of delayed-enhancement cardiovascular magnetic resonance imaging in predicting myocardial viability after surgical revascularization.Circulation. 2004; 110: 1535-1541
- Fundamental concepts in myocardial viability assessment revisited: when knowing how much is “alive” is not enough.Heart. 2004; 90: 137-140
- Gadolinium Cardiovascular Magnetic Resonance predicts reversible myocardial dysfunction and remodeling in patients with heart failure undergoing ß-blocker therapy.Circulation. 2003; 108: 1945-1953
- Effects of carvedilol on left ventricular remodeling in chronic stable heart failure: a cardiovascular magnetic resonance study.Heart. 2004; 90: 760-764
- Reduction in sample size for studies of remodeling in heart failure by the use of cardiovascular magnetic resonance.J Cardiovasc Magn Reson. 2000; 2: 271-278
- Contrast magnetic resonance imaging in the assessment of myocardial viability in patients with stable coronary artery disease and left ventricular dysfunction.Circulation. 1998; 98: 2687-2694
- 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: 374-379
- Assessment of myocardial viability with contrast-enhanced magnetic resonance imaging. Comparison with positron emission tomography.Circulation. 2002; 105: 162-167
- Myocardial viability in chronic ischemic heart disease: comparison of contrast-enhanced magnetic resonance imaging with (18)F-fluorodeoxyglucose positron emission tomography.J Am Coll Cardiol. 2003; 41: 1341-1348
- Characterization of dysfunctional myocardium by positron emission tomography and magnetic resonance: relation to functional outcome after revascularization.Circulation. 2003; 108: 1095-1100
- Assessment of reversible myocardial dysfunction in chronic ischaemic heart disease: comparison of contrast-enhanced cardiovascular magnetic resonance and a combined positron emission tomography-single photon emission computed tomography imaging protocol.Eur Heart J. 2006; 27: 846-853
- 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
- Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the definition and classification of cardiomyopathies.Circulation. 1996; 93: 841-842
- Idiopathic dilated cardiomyopathy. An immunologic, genetic or infectious disease, or all of the above?.Circulation. 1991; 83: 704-706
- Visualisation of presence, location, and transmural extent of healed Q-wave and non-Q-wave myocardial infarction.Lancet. 2001; 357: 21-28
- Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium-enhanced cardiovascular magnetic resonance.Circulation. 2003; 108: 54-59
- Idiopathic dilated cardiomyopathy: analysis of 152 necropsy patients.Am J Cardiol. 1987; 60: 1340-1355
- Cardiovascular magnetic resonance, fibrosis and prognosis in dilated cardiomyopathy.J Cardiovasc Magn Reson. 2006; 8 ([abstract]): 3-4
- Hypertrophic Cardiomyopathy.in: Zipes D.P. Libby P. Bonow R.O. Braunwald E. Braunwald's Heart Disease: a textbook of cardiovascular medicine. Elsevier Saunders, Philadelphia, Pennsylvania2005: 1667-1682
- Myocardial scarring in asymptomatic or mildly symptomatic patients with hypertrophic cardiomyopathy.J Am Coll Cardiol. 2002; 40: 2156-2164
- Toward clinical risk assessment in hypertrophic cardiomyopathy with gadolinium cardiovascular magnetic resonance.J Am Coll Cardiol. 2003; 41: 1561-1567
- Myocardial infarction after percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: evaluation by contrast-enhanced magnetic resonance imaging.J Am Coll Cardiol. 2004; 43: 27-34
- Early onset and progression of left ventricular remodeling after alcohol septal ablation in hypertrophic obstructive cardiomyopathy.Circulation. 2005; 111: 2503-2508
- Gadolinium enhanced cardiovascular magnetic resonance in Anderson–Fabry disease. Evidence for a disease specific abnormality of the myocardial interstitium.Eur Heart J. 2003; 24: 2151-2155
- Arrhythmogenic right ventricular cardiomyopathy.J Am Coll Cardiol. 2001; 38: 1773-1781
- Noninvasive detection of myocardial fibrosis in arrhythmogenic right ventricular cardiomyopathy using delayed-enhancement magnetic resonance imaging.J Am Coll Cardiol. 2005; 45: 98-103
- Diagnosis of arrhythmogenic right ventricular dysplasia/cardiomyopathy.Br Heart J. 1994; 71: 215-218
- Myocarditis: a histopathologic definition and classification.Am J Cardiovasc Pathol. 1987; 1: 3-14
- Contrast media-enhanced magnetic resonance imaging visualizes myocardial changes in the course of viral myocarditis.Circulation. 1998; 97: 1802-1809
- Cardiovascular magnetic resonance assessment of human myocarditis; a comparison to histology and molecular pathology.Circulation. 2004; 109: 1250-1258
- Cardiac sarcoid: a clinicopathologic study of 84 unselected patients with systemic sarcoidosis.Circulation. 1978; 58: 1204-1211
- Delayed enhancement cardiovascular magnetic resonance assessment of non-ischaemic cardiomyopathies.Eur Heart J. 2005; 26: 1461-1474
- Sarcoidosis of the cardiac conducting system.Am Heart J. 1979; 97: 701-707
- Cardiac and neurologic dysfunction in sarcoidosis.Clin Chest Med. 1997; 18: 813-825
- Diagnosis of cardiac sarcoidosis and evaluation of the effects of steroid therapy by gadolinium-DTPA-enhanced magnetic resonance imaging.Am J Med. 2001; 110: 520-527
- Clinical significance of myocardial magnetic resonance abnormalities in patients with sarcoidosis: a 1-year follow-up study.Chest. 2002; 122: 1895-1901
- Prognostic determinants of long-term survival in Japanese patients with cardiac sarcoidosis treated with prednisone.Am J Cardiol. 2001; 88: 1006-1010
- Restrictive and infiltrative cardiomyopathies.in: Zipes D.P. Libby P. Bonow R.O. Braunwald E. Braunwald's heart disease: a textbook of cardiovascular medicine. Elsevier Saunders, Philadelphia, Pennsylvania2005: 1682-1692
- Cardiovascular magnetic resonance in cardiac amyloidosis.Circulation. 2005; 111: 186-193
- Nonischemic myocardial disease.in: Bogart J. Dymarkowski S. Taylor A.M. Clinical cardiac MRI. Springer, Berlin, Germany2005: 217-271
- Myocardial delayed enhancement by magnetic resonance imaging in patients with Chagas’ disease: a marker of disease severity.J Am Coll Cardiol. 2005; 46: 1553-1558
- Estimation of right ventricular mass in normal subjects and in patients with primary pulmonary hypertension by nuclear magnetic resonance imaging.J Am Coll Cardiol. 1993; 21: 1475-1481
- Direct quantitation of right and left ventricular volumes with nuclear magnetic resonance imaging in patients with primary pulmonary hypertension.J Am Coll Cardiol. 1992; 19: 1508-1515
- Patients with pulmonary fibrosis: cardiac function assessed with MR imaging.Radiology. 2000; 216: 464-471
- Contrast enhanced-cardiovascular magnetic resonance imaging in patients with pulmonary hypertension.Eur Heart J. 2005; 26: 1993-1999
Article info
Publication history
Accepted:
September 22,
2006
Received in revised form:
August 15,
2006
Received:
July 8,
2006
Identification
Copyright
© 2006 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.