Protocol
  1. Anatomy module (A)
  2. LV function module (B)
  3. Edema module (G)
  4. EGE/LGE module (E)

Report
  1. Dimensions (corrected for BSA) and function
    • LV: EDV, ESV, SV, EF
    • RV: EDV, ESV, SV, EF
    • Regional wall motion abnormalities
  2. Presence of edema (=area at risk)
  3. Presence and transmural extent of scar
  4. Presence and extent of microvascular obstruction (MVO)

Key Points
  1. T2w imaging may differentiate acute from chronic myocardial infarction
  2. Microvascular obstruction:
    • Equates to angiographic “no reflow” appearance
    • High risk feature
  3. Risk assessment:
    • Infarction size
    • LV / RV function
    • MVO
  4. Assessment of LV thrombus on EGE images

Tips and Tricks
  1. MVO best seen on EGE images at TI > 400ms
  2. T2w images must be acquired before contrast administration
  3. Compare LGE images with cine images if unsure about differentiation between blood pool and endocardial late enhancement

References