Tissue Characterization of the Myocardium: State of the Art Characterization by Magnetic Resonance and Computed Tomography Imaging

Late gadolinium enhancement (LGE) is a simple, robust, well-validated method for assessing scar in acute and chronic myocardial infarction. LGE is useful for distinguishing between ischemic and nonischemic cardiomyopathy. Specific LGE patterns are seen in nonischemic cardiomyopathy. Patient studies using T1 mapping have varied in study, design, and acquisition sequences. Despite the differences in technique, a clear pattern that has been seen is that in cardiac disease postcontrast T1 times are shorter. Extracellular volume fraction measured with cardiac computed tomography represents a new approach to the clinical assessment of diffuse myocardial fibrosis by evaluating the distribution of iodinated contrast.