MRI
2 chamber left BTFE
2 chamber left BTFE
4 chamber BTFE cine
4 chamber BTFE cine
short axis BTFE cine
short axis BTFE cine
short axis ms cine video
short axis ms cine images
LVOT BTFE cine
LVOT BTFE cine
2 chamber left viability
4 chamber viability
short axis perfusion stress - apical
short axis viability
short axis perfusion stress - mid-ventricular
short axis perfusion stress - basal
4 chamber perfusion stress
short axis perfusion rest - apical
short axis perfusion rest - mid-ventricular
short axis Look Locker
short axis perfusion rest - basal
4 chamber perfusion rest
Survey
Normal ventricular diameters (LV 54 mm and RV 32 mm). Interventricular septum within normal range (10 mm). LV ejection fraction within normal range (53%).
Slight hypokinesia of apex and anterior apical wall.
Late enhancement of inferior apical LV wall, <50% wall thickness, in keeping with infarcted, but viable myocardium (short axis viability series).
Possible late enhancement of anterior apical LV wall, no clear infarction.
On perfusion images there is a perfusion defect at the site of inferior wall infarction. On rest images otherwise normal enhancement of myocardium. However, on stress images there is a subendocardial perfusion defect of the basal and mid-ventricular midseptal wall, suggestive of ischemia (perfusion stress video mid-ventricular).
Conclusion:
- Ischemia midventricular and basal central interventricular septum.
- Infarcted, but viable inferior apical LV wall.
- Slightly hypokinetic anterior apical LV wall with minimal late enhancement, not convincing for true infarction.