Controversies in cardiovascular MR imaging: Reasons why imaging myocardial T2 has clinical and pathophysiologic value in acute myocardial infarction

摘要

T2-weighted imaging in the assessment of magnetic resonance (MR) imaging of myocardial area at risk has recently generated a great deal of interest but has also caused substantial controversy. The area at risk (1) represents the amount of myocardium that is hypoperfused during coronary occlusion (Fig 1). Since the infarct is a subset of the area at risk, the difference between the two measures is the amount of myocardium salvaged, which is a measure of therapeutic efficacy. The purpose of this article is to discuss the role of T2-weighted MR imaging in assessment of the area at risk in patients with acute myocardial infarction. Some investigators have raised doubts about the veracity and feasibility of using T2-weighted images to measure the area at risk. However, mounting evidence indicates that T2-weighted images can be used not only to measure the area at risk but also to refine our understanding of gadolinium-enhanced myocardium in the setting of acute myocardial infarction, as well as the pathophysiology of acute myocardial infarction in general.