EURORAD ESR

Case 5991

MR imaging of cardiac impending rupture

Author(s)
Federica Fiocchi, Guido Ligabue, Pietro Torricelli
 
Patient
male, 54 year(s)
 
 
  • Figure 1
    Figure 1 A, B. Balanced Fast Field Echo images on four chambers view (A) and three chambers view...

    Notice the thinning of heart apex, with slow flow due to akinesis in figure A. Three chambers view (B) shows the extreme thinning of the inferior wall

     
     
     
  • Figure 2
    Figure 2 A, B. T2 weighted Spin Echo images on two chambers view.

    The thinning and the aneurysmatic conformation of the apex can be seen (A); furthermore, in figure B, a high signal intensity of the inferior myocardial wall is appreciable and to be distinguished from the flow...

     
     
     
  • Figure 3
    Figure 3. Balanced Fast Field Echo images on two chambers view.

    This image clearly shows the sub-epicardial aneurysm development (*) in relation to the myocardial tissue alteration of the inferior-apical segments. The outer lining is the epicardium. Discrete pericardial effusion...

     
     
     
  • Figure 4
    Figure 4. T1 weighted Fast Field Echo image during bolus injection of gadoterate meglumine 0.15...

    Here is noticeable the perfusion defect of the inferior wall and the presence of contrast media in the former described sub-epicardial aneurysm.

     
     
     
  • Figure 5
    Figure 5 A, B. T1 weighted Turbo Fast low angle shot sensitivity encoded sequence with a...

    The delayed enhanced images on two (A) and four (B) chambers view show a transmural infarction of the anterior and of the apex with areas of myocardial obstruction. The inferior wall is also compromised.

     
     
     
Notice the thinning of heart apex, with slow flow due to akinesis in figure A. Three chambers view (B) shows the extreme thinning of the inferior wall
 
The thinning and the aneurysmatic conformation of the apex can be seen (A); furthermore, in figure B, a high signal intensity of the inferior myocardial wall is appreciable and to be distinguished from the flow artefacts present on the same region. The hyper-intensity can be compatible with both oedema due to the acute infarction and impending rupture state.
 
This image clearly shows the sub-epicardial aneurysm development (*) in relation to the myocardial tissue alteration of the inferior-apical segments. The outer lining is the epicardium. Discrete pericardial effusion is also present.
 
Here is noticeable the perfusion defect of the inferior wall and the presence of contrast media in the former described sub-epicardial aneurysm.
 
The delayed enhanced images on two (A) and four (B) chambers view show a transmural infarction of the anterior and of the apex with areas of myocardial obstruction. The inferior wall is also compromised.
 
 
 
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