Delayed myocardial enhancement

Last revised by Tee Yu Jin on 16 Dec 2019

Delayed myocardial enhancement, as seen on cardiac MRI, occurs when gadolinium contrast material seeps into fibrotic or necrotic myocardial tissue. It is due to a number of etiologies, and has variable appearances.

  1. subendocardial enhancement indicates an ischemic etiology
  2. transmural enhancement is nonspecific, but suggestive of an ischemic etiology
  3. mid-wall enhancement indicates a non-ischemic etiology (e.g. myocarditis, idiopathic dilated cardiomyopathy)
  4. diffuse patchy areas of enhancement are seen in cardiac amyloidosis

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Cases and figures

  • Case 1: anteroseptal infarction
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