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Gadolinium-based extracellular contrast agents have enabled cardiac magnetic resonance (CMR) to assess viability and fibrosis at higher resolution than alternative technologies.(Kim, Fieno et al. 1999) In this issue of JACC Cardiovascular Imaging, Hidenari Matsumoto et al from Rakuwakai Otowa Hospital, in Kyoto, Japan present convincing data that early contrast enhancement approximately 2 minutes after administration of gadolinium depicts the area at risk associated with acute myocardial infarction. The convenience of imaging both area at risk and infarct size from the same bolus of gadolinium proffers to be a huge convenience factor in expediting the assessment of myocardial salvage but this “two-for-one” benefit is accompanied by the need to understand the kinetics of gadolinium in the infarct and the peri-infarct zone.

Gadolinium Can Depict Area at Risk and Myocardial Infarction