CMR provides unsurpassed methods for exact quantification of cardiac function and volumes as well as tissue characterization for the identification of myocardial edema and necrosis.
24-year-old male with new onset chest pain for 12 hours, ubiquitous changes of the ST-segment and elevated troponin levels five days after suffering from severe gastroenteritis. Immediately performed invasive coronary angiography did not demonstrate any obstructive coronary disease. CMR was carried out the day after admission to the hospital.
Standard CMR using cine SSFP for assessment of global and regional LV- and RV-function, T2-weighted imaging and contrast enhanced images for tissue characterization.
Breath hold was about 8-12 seconds. Spatial resolution was between 1.5 x 1.5 and 2.0 x 2.0 mm.
MR images and interpretation
Cine SSFP (see video 1 and 2) demonstrates slightly depressed global LV-function with subtle, hypokinesia of the apical lateral wall. T2-weighted images (Figure 1) and late gadolinium enhancement (Figure 2 and 3) show diffuse, epicardially pronounced edema and myocardial necrosis (white arrows).