The emerging role of delayed contrast-enhanced magnetic resonance imaging in the peri-operative evaluation of patients undergoing coronary revascularisation

This editorial refers to “Visualization and quantification of peri-operative myocardial infarction after coronary artery bypass surgery with contrast-enhanced magnetic resonance imaging”1 by J. Steuer et al. on page 1293In this issue of the journal, Steuer et al.1 describe the application of delayed contrast-enhanced magnetic resonance imaging (MRI) for the identification, characterisation and quantification of peri-operative myocardial infarction. Contrast-enhanced MRI was performed 4–9 days after coronary bypass surgery. Hyper-enhanced myocardial areas, representing myocardial necrosis, were identified in 18 of 23 patients. Biochemical markers of myocardial damage including creatinine kinase (CK-MB), troponin I and troponin T correlated with the mass of infarction. Most of the patients demonstrated patchy distribution of necrosis suggesting global, peri-operative ischaemia. However, those patients with high post-operative CK-MB levels (above five times the upper reference level) demonstrated more localised areas of infarctions. These results demonstrate the potential role of delayed contrast-enhanced MRI in the understanding … *Correspondence to: Paul Schoenhagen, Department of Cardiology/Radiology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Radiology Desk Hb-6, Cleveland, OH 44195, USA. Tel.: +1-216-445-7579; fax: +1-216-445-6855
 E-mail address: schoenp1{at}ccf.org