Myocardial viability assessment by contrast-enhanced magnetic resonance imaging.

Recent progress in the diagnosis and treatment of coronary artery disease has intensified the need to differentiate viable from nonviable myocardium with accuracy and high spatial resolution. Contrast-enhanced magnetic resonance imaging (MRI) had been investigated as a potential technique to assess myocardial viability for several years (1), before the development of gradient echo-imaging techniques provided the ability to temporally distinguish perfusion abnormalities created by microvascular obstruction from myocardial hyperenhancement secondary to myocardial necrosis (2,3). The prognostic value of contrast-enhanced MRI in patients with acute myocardial infarction (AMI) is well established (4). However, recent work on the specific utilization of this technique for the purpose of predicting local functional recovery after AMI (5,6) has further expanded its potential utilization in state-of-the-art cardiology practice. The work by Beek et al. (7) in this issue of the Journal represents an important addition to our knowledge in this field.