Gadolinium-Enhancedmagnetic resonance imagingin hypertrophic cardiomyopathy

In vivo magnetic resonance imaging (MRI) of the heart with gadolinium-based contrast agents has been performed since the mid-1980s (1). A major limitation of the initial techniques was insufficient image contrast between normal and infarcted myocardium. Recently, a number of studies have demonstrated the effectiveness of a new segmented inversion recovery MRI pulse sequence for differentiating normal from infarcted myocardium with signal intensity differences of nearly 500% (2,3). This new technique for gadolinium-enhanced MRI has been shown to be effective in identifying the presence, location, and extent of myocardial infarction in both the acute and chronic settings (3–5). Furthermore, this technique has been validated in animal models of ischemic injury (2,6,7), provides scar size measurements that are closely correlated with positron emission tomography in patients with ischemic cardiomyopathy (8), and provides results superior to single-photon emission computed tomography perfusion imaging in patients with small myocardial infarctions (9).