Imaging myocardial edema

Abstract

Cardiac magnetic resonance (CMR) imaging offers a powerful noninvasive technique for assessing the effects of ischemia-reperfusion injury in the context of acute coronary syndrome (ACS). T2-weighted CMR sequences performed after coronary occlusion accurately identify regions of myocardial edema downstream of the obstructed vessel that enables retrospective determination of the area at risk. Comparing the area at risk with gadolinium-enhanced infarct sizing provides an important tool for clinical decision making and research as it defines the degree of heart muscle salvage following an ischemic injury. The currently available techniques for assessing myocardial edema in ACS are described in this review with an overview of how these inform our understanding of myocardial salvage following primary coronary intervention.