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Late gadolinium enhancement (LGE) and T1 mapping allow infarction and fibrosis to be identified for characterizing cardiomyopathy and assessing viability. [8] Magnetic resonance angiography may be performed with or without contrast medium and is used to assess congenital or acquired abnormalities of the coronary arteries and great vessels. [9]
They include gadolinium and manganese chelates, or iron salts for T 1 signal enhancement. SPIO, barium sulfate , air and clay have been used to lower T 2 signal. Natural products with high manganese concentration such as blueberry and green tea can also be used for T 1 increasing contrast enhancement.
This leads to a signal increase which can be visualised with the "late gadolinium enhancement technique." This is probably the most accurate way to visualise scarred myocardium. An alternative (or additional) technique with CMR is the use of low dose dobutamine similar to echocardiography.
The Lake Louise Criteria include increased signal intensity after gadolinium contrast enhancement (a sign of hyperemia, or increased blood flow to damaged tissue), increased myocardial T2 relaxation time or an increased T2 signal intensity (which are signs of tissue edema or swelling), and late gadolinium contrast enhancement (which is a sign ...
Additional benefits from cardiac MRI include the ability to detect scar within the heart using late gadolinium enhancement, and identify other abnormalities of the heart muscle itself such as infiltration with iron or amyloid protein. [11] Disadvantages of MRI include lengthy protocols and the potential for claustrophobia.
The Impact of the Relaxivity Definition on the Quantitative Measurement of Glycosaminoglycans in Cartilage by MRI dGEMRIC Method; Delayed Gadolinium-enhanced MR Imaging of Articular Cartilage: Three-dimensional T1 Mapping with Variable Flip Angles and B1 Correction; Toward Imaging Biomarkers for Glycosaminoglycans
The contrast agents used for DCE-MRI are often gadolinium based. Interaction with the gadolinium (Gd) contrast agent (commonly a gadolinium ion chelate) causes the relaxation time of water protons to decrease, and therefore images acquired after gadolinium injection display higher signal in T1-weighted images indicating the present of the agent.
Late-gadolinium enhancement on cardiac MRI indicates the presence of fibrosis and scarring, and may be evidence of cardiomyopathy not due to tachycardia. [ 1 ] [ 5 ] A decline in serial NT-pro BNP with control of tachyarrhythmia indicates reversibility of the cardiomyopathy, which would also suggest TIC.