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Delayed-enhancement cardiac MRI in the evaluation of cardiomyopathies

Thananya Boonyasiranant and Scott D Flamm

Cardiomyopathies are a diverse group of disorders with etiologies ranging from ischemic to infiltrative. Clinical differentiation may be complex, but diagnosis is essential as complications include congestive heart failure and sudden death. Recent developments in cardiac MRI, particularly the implementation of delayed-enhancement imaging has introduced a novel approach to noninvasive tissue characterization that can more accurately differentiate the spectrum of cardiomyopathies. This article summarizes the comprehensive diagnostic abilities of cardiac MRI in defining cardiac anatomy and physiology and, more importantly, identifying pathologic tissues and differentiating those with substrates amenable to therapy. The value of delayed-enhancement imaging in prognostics will also be presented.