MRI - Perfusion and viability module (Gadolinium first pass and LGE)
Short axis (basal) Perfusion
Short axis (mid ventricular) Perfusion
Short axis (apical) Perfusion
Short axis stack Phase sensitive Inversion recovery (PSIR) LGE
First pass or perfusion images: subendocardial perfusion defect (absence of signal, dark or black) in LAD territory.
Late gadolinium enhancement: depicts transmural infarction (transmural hyperintensity, bright or white), also shows "no-reflow" phenomenon (an endocardial rim of absent signal even in LGE images).
Revascularization has a poor outcome in transmural infarction (considered non-viable tissue) and the presence of the "no-reflow" phenomenon has a poor prognosis.