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Differential diagnosis of delayed myocardial enhancement on MRI

Dr Yuranga Weerakkody et al.

Delayed myocardial enhancement can occur in cardiac MR assessment due to a number of causes

They include

myocardial ischaemia : typically subendocardial and follows a vascular territory ¹
non ischaemic cardiomyopathies
cardiac amyloidosis
cardiac sarcoidosis
myocarditis : tends to be more nodular and subepicardial
local trauma or post ablation
cardiac involvement in hyper eosinophillic syndrome
muscular dystrophies
- Duchenne muscular dystrophy
- Becker muscular dystrophy
cardiac vasculitides
- Kawasaki syndrome ²

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References

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1. Lim RP, Srichai MB, Lee VS. Non-ischemic causes of delayed myocardial hyperenhancement on MRI. AJR Am J Roentgenol. 2007;188 (6): 1675-81. doi:10.2214/AJR.06.1224 - Pubmed citation
2. Vogel-claussen J, Rochitte CE, Wu KC et-al. Delayed enhancement MR imaging: utility in myocardial assessment. Radiographics. 26 (3): 795-810. doi:10.1148/rg.263055047 - Pubmed citation