CMR Visualization of Cardiac Amyloid Infiltration: Challenges and Opportunities
Cardiovascular magnetic resonance (CMR) is an indispensible clinical tool that can identify the etiology of cardiomyopathy. Unlike other non-invasive imaging modalities, CMR leverages its intrinsic capacity to characterize tissue based upon fundamental MR properties (T1 and T2) and in so doing can differentiate normal from diseased myocardium. Following the administration of the exogenous contrast agent gadolinium, which is retained in areas of increased interstitial space, intrinsic MR differences are accentuated permitting selective visualization of fibrosis and infarction by means of late gadolinium enhancement (LGE). LGE, arguably one of the most important innovations in the history of CMR, works best when the border between normal and abnormal is distinct and the region of abnormality is sufficiently different so as to result in significant gadolinium accumulation, thereby shortening T1 and rendering a high signal intensity difference from normal myocardium.
- Received September 1, 2015.
- Accepted September 4, 2015.