Infarction and delayed enhancement
Infarcted myocardium is bright on late-enhancement images.All patients with ischemic cardiomyopathy demonstrate delayed enhancement in a typical 'CAD' pattern, one in which the subendocardium is always involved.
When a coronary artery is occluded the infarction always starts subendocardially and progresses towards the epicardium depending on the duration of the occlusion [6].
Both acute and chronic infarctions enhance.
In acute infarctions the contrast enters the damaged myocardial cells due to myocyte membrane disruption.
In chronic infarctions the late enhancement is a result of retention of contrast material in the large interstitial space between the collagen fibers in the fibrotic tissue [7].
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| Left: subendocardial infarction, Right: transmural infarction |
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