Department of Radiology, UCSF Medical Center, 505 Parnassus Ave, Room L308, Box 0628, San Francisco, CA 94143-0628, USA.
Radiology. 2011 Nov;261(2):358-74. doi: 10.1148/radiol.11091882.
Differential enhancement of myocardial infarction was first recognized on computed tomographic (CT) images obtained with iodinated contrast material in the late 1970s. Gadolinium enhancement of myocardial infarction was initially reported for T1-weighted magnetic resonance (MR) imaging in 1984. The introduction of an inversion-recovery gradient-echo MR sequence for accentuation of the contrast between normal and necrotic myocardium was the impetus for widespread clinical use for demonstrating the extent of myocardial infarction. This sequence has been called delayed-enhancement MR and MR viability imaging. The physiologic basis for differential enhancement of myocardial necrosis is the greater distribution volume of injured myocardium compared with that of normal myocardium. It is now recognized that delayed enhancement occurs in both acute and chronic (scar) infarctions and in an array of other myocardial processes that cause myocardial necrosis, infiltration, or fibrosis. These include myocarditis, hypertrophic cardiomyopathy, amyloidosis, sarcoidosis, and other myocardial conditions. In several of these diseases, the presence and extent of delayed enhancement has prognostic implications. Future applications of delayed enhancement with development of MR imaging and CT techniques will be discussed.
在 20 世纪 70 年代末，人们首次在使用碘造影剂的计算机断层扫描（CT）图像上发现心肌梗死的差异增强。1984 年，最初在 T1 加权磁共振（MR）成像上报告了钆增强的心肌梗死。反转恢复梯度回波 MR 序列的引入，用于强调正常和坏死心肌之间的对比度，这是促使其广泛应用于临床，以显示心肌梗死范围的动力。该序列被称为延迟增强磁共振成像和磁共振存活成像。心肌坏死差异增强的生理基础是损伤心肌的分布容积大于正常心肌。现在人们认识到，延迟增强不仅发生在急性和慢性（疤痕）梗死中，还发生在一系列其他导致心肌坏死、浸润或纤维化的心肌过程中。这些包括心肌炎、肥厚型心肌病、淀粉样变性、结节病和其他心肌疾病。在这些疾病中的几种疾病中，延迟增强的存在和程度具有预后意义。将讨论随着磁共振成像和 CT 技术的发展，延迟增强的未来应用。
