CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2011; 21(02): 124-133
DOI: 10.4103/0971-3026.82297
Cardiac Radiology

Utility of magnetic resonance imaging in the evaluation of patients with ST segment elevation on an electrocardiogram

Prabhakar Rajiah
Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
› Author Affiliations
Financial support and sponsorship Nil.

Abstract

ST segment elevation is an important electrocardiographic (ECG) change that is typically found in acute myocardial infarction, but may also be seen in a variety of other conditions. MRI plays an important role in the evaluation of these patients. MRI not only establishes the diagnosis, which is essential for appropriate management, but also helps in the assessment of other factors that are important for risk stratification. In this review, we discuss the common and uncommon causes of ST segment elevation and the role of MRI in the evaluation of these disease processes.



Publication History

Article published online:
30 July 2021

© 2011. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 
  • References

  • 1 Wang K, Asinger RW, Marriott HJ. ST-Segment elevation in conditions other than acute myocardial infarction. N Engl J Med 2003;349:2128-35.
  • 2 Brady W. ST-segment elevation in ED adult chest pain patients: Etiology and diagnostic accuracy for AMI. J Emerg Med 1998;16:797-8.
  • 3 Otto LA, Aufderheide TP. Evaluation of ST segment elevation criteria for prehospital electrocardiographic diagnosis of acute myocardial infarction. Ann Emerg Med 1994;23:17-24.
  • 4 Assomull RG, Lyne JC, Keenan N, Gulati A, Bunce NH, Davies SW, et al. The role of cardiovascular magnetic resonance in patients presenting with chest pain, raised troponin, and unobstructed coronary arteries. Eur Heart J 2007;28:1242-9.
  • 5 Leiner T, Kucharczyk W. NSF prevention in clinical practice: Summary of recommendations and guidelines in the United States, Canada, and Europe. J Magn Reson Imaging 2009;30:1357-63.
  • 6 Abdel-Aty H, Simonetti O, Friedrich MG. T2-weighted cardiovascular magnetic resonance imaging. J Magn Reson Imaging 2007;26:452-9.
  • 7 Schwitter J, Wacker CM, van Rossum AC, Lombardi M, Al-Saadi N, Ahlstrom H, et al. MR-IMPACT: Comparison of perfusion CMR with SPECT for the detection of coronary artery disease in a multicentre, multivendor, randomized trial. Eur Heart J 2008;29:480-9.
  • 8 Kellman P, Arai AE. Imaging sequences for first pass perfusion- A review. J Cardiovasc Magn Reson 2007;9:525-37.
  • 9 Fieno DS, Shea SM, Li Y, Harris KR, Finn JP, Li D. Myocardial perfusion imaging based on the blood oxygen level-dependent effect using T2-prepared steady-state free-precession magnetic resonance imaging. Circulation 2004;110:1284-90.
  • 10 Kim RJ, Wu E, Rafael A, Chen EL, Parker MA, Simonetti O, et al. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med 2000;343:1445-53.
  • 11 Kim HW, Farzaneh-Far A, Kim RJ. Cardiovascular magnetic resonance in patients with myocardial infarction: Current and emerging applications. J Am Coll Cardiol 2009;55:1-16.
  • 12 Kwong RY, Schussheim AE, Rekhraj S, Aletras AH, Geller N, Davis J, et al. Detecting acute coronary syndrome in the emergency department with cardiac magnetic resonance imaging. Circulation 2003;107:531-7.
  • 13 Cury RC, Shash K, Nagurney JT, Rosito G, Shapiro MD, Nomura CH, et al. Cardiac magnetic resonance with T2-weighted image improves detection of patients with acute coronary syndrome in the emergency department. Circulation 2008;118:837-44.
  • 14 Friedrich MG, Sechtem U, Schulz-Menger J, Holmvang G, Alakija P, Cooper LT, et al; International Consensus Group on Cardiovascular Magnetic Resonance in Myocarditis. Cardiovascular magnetic resonance in myocarditis: A JACC White Paper. J Am Coll Cardiol 2009;53:1475-87.
  • 15 Mahrholdt H, Wagner A, Deluigi CC, Kispert E, Hager S, Meinhardt G, et al. Presentation, patterns of myocardial damage, and clinical course of viral myocarditis. Circulation 2006;114:1581-90.
  • 16 Bogaert J, Francone M. Cardiovascular Magnetic resonance in pericardial diseases. J Cardiovasc Magn Reson 2009;11:14.
  • 17 Pilgrim TM, Wyss TR. Takotsubo cardiomyopathy or transient left ventricular apical ballooning syndrome: A systematic review. Int J Cardiol 2008;124:283-92.
  • 18 Moon JC, McKenna WJ, McCrohon JA, Elliott PM, Smith GC, Pennell DJ. Toward clinical risk assessment in hypertrophic cardiomyopathy with gadolinium cardiovascular magnetic resonance. J Am Coll Cardiol 2003;41:1561-7.
  • 19 Kwon DH, Desai MY. Cardiac magnetic resonance in hypertrophic cardiomyopathy: Current state of the art. Expert Rev Cardiovasc Ther 2010;8:103-11.
  • 20 Napodano M, Tarantini G, Ramondo A, Cacciavillani L, Corbetti F, Marra MP, et al. Myocardial abnormalities underlying persistent ST-segment elevation after anterior myocardial infarction. J Cardiovasc Med (Hagerstown) 2009;10:44-50.
  • 21 Konen E, Merchant N, Gutierrez C, Provost Y, Mickleborough L, Paul NS, et al. True versus false left ventricular aneurysm: Differentiation with MR imaging-initial experience. Radiology 2005;236:65-70.
  • 22 Vignaux O. Cardiac sarcoidosis: Spectrum of MRI features. AJR Am J Roentgenol 2005;184:249-54.
  • 23 Clough RE, Schaeffter T, Taylor PR. Magnetic resonance imaging for aortic dissection. Eur J Vasc Endovasc Surg 2010;39:514.
  • 24 Litmanovich D, Bankier AA, Cantin L, Raptopoulous V, Boiselle PM. CT and MRI in diseases of the aorta. AJR Am J Roentgenol 2009;193:928-40.
  • 25 Stein PD, Chenevert TL, Fowler SE, Goodman LR, Gottschalk A, Hales CA, et al. Gadolinium- enhanced magnetic resonance angiography for pulmonary embolism: A multicenter prospective study (PIOPED III). Ann Intern Med 2010;152:434-43, W142-3.
  • 26 Kayser HW, van der Wall EE, Sivananthan MU, Plein S, Bloomer TN, de Roos A. Diagnosis of arrhythmogenic right ventricular dysplasia: A review. Radiographics 2002;22:639-50.
  • 27 Cox MG, van der Smagt JJ, Noorman M, Wiesfeld AC, Volders PG, van Langen IM, et al. Arrhythmogenic right ventricular dysplasia/cardiomyopathy diagnostic task force criteria: Impact of new task force criteria. Circ Arrhythm Electrophysiol 2010;3:126-33.
  • 28 Tandri H, Saranathan M, Rodriguez ER, Martinez C, Bomma C, Nasir K, et al. Noninvasive detection of myocardial fibrosis in arrhythmogenic right ventricular cardiomyopathy using delayed enhancement magnetic resonance imaging. J Am Coll Cardiol 2005;45:98-103.
  • 29 Meregalli PG, Wilde AA, Tan HL. Pathophysiological mechanisms of Brugada syndrome: Depolarization disorder, repolarization disorder, or more? Cardiovasc Res 2005;67:367-78.
  • 30 Catalano O, Antonaci S, Moro G, Mussida M, Frascaroli M, Baldi M, et al. Magnetic resonance investigations in Brugada syndrome reveal unexpectedly high rate of structural abnormalities. Eur Heart J 2009;30:2241-8.
  • 31 Muellerleile K, Stork A, Bansmann M, Barmeyer A, Dinkelacker A, Baholli L, et al. Detection of mechanical ventricular asynchrony by high temporal resolution cine MRI. Eur Radiol 2008;18:1329-37.