Author + information
- Charles Cannan, MBChB⁎†,
- Ingo Eitel, MD⁎‡,
- James Hare, MBBS⁎§,
- Andreas Kumar, MD⁎ and
- Matthias Friedrich, MD⁎⁎ ()
- ↵⁎Address for correspondence:
Dr. Matthias Friedrich, Stephenson Cardiovascular MR Center, Foothills Medical Center, 1403 - 29th Street NW, Suite 0700, 1403 - Special Services Building, Calgary, AB T2N 2T9 Canada
hemorrhage in the myocardium following myocardial infarction, especially larger amounts, leads to severe regional inflammation and affects the healing process as well as local physiology. Thus, detection of myocardial hemorrhage by noninvasive techniques such as cardiac magnetic resonance could add to risk stratification following myocardial infarction. Some studies on the importance of myocardial hemorrhage following myocardial infarction have used a T2-weighted short tau inversion time (STIR) method to document myocardial hemorrhage (1). Decreased signal intensity within the area of edema visualized by T2-weighted STIR has been considered indicative of myocardial hemorrhage (2). However, microvascular obstruction—which may not be associated with hemorrhage—may also be represented by a drop in signal intensity within the area of edema seen on T2-weighted STIR imaging (3) (Fig. 2B). Microvascular obstruction is also represented on late gadolinium enhancement images as a nonenhancing central core surrounded by late gadolinium enhancement (Fig. 2A and 2C; Fig. 3A and 3C).
T2⁎ imaging of the myocardium (Fig. 2D and Fig. 3D) has been shown to detect the paramagnetic effects of iron or hemorrhage in the myocardium (4). In order to more accurately assess the presence or absence of hemorrhage within the zone of myocardial infarction, a T2* imaging technique should be considered in addition to T2-weighted imaging.
We present clinical cases following ST-segment elevation myocardial infarction with similar findings on T2-weighted images and late gadolinium enhancement yet different post-infarct reperfusion treatment. The utility of T2* imaging is demonstrated (Figs. 1 and 4).⇓
- American College of Cardiology Foundation