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BioMed Research International
Volume 2015, Article ID 859073, 8 pages
Review Article

Intramyocardial Hemorrhage: An Enigma for Cardiac MRI?

1Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, La Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
2Department of Radiology, La Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy

Received 31 January 2014; Revised 25 September 2014; Accepted 8 October 2014

Academic Editor: Jiang Du

Copyright © 2015 Camilla Calvieri et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Cardiovascular magnetic resonance (CMR) is a useful noninvasive technique for determining the presence of microvascular obstruction (MVO) and intramyocardial hemorrhage (IMH), frequently occurring in patients after reperfused myocardial infarction (MI). MVO, or the so-called no-reflow phenomenon, is associated with adverse ventricular remodeling and a poor prognosis during follow-up. Similarly, IMH is considered a severe damage after revascularization by percutaneous primary coronary intervention (PPCI) or fibrinolysis, which represents a worse prognosis. However, the pathophysiology of IMH is not fully understood and imaging modalities might help to better understand that phenomenon. While, during the past decade, several studies examined the distribution patterns of late gadolinium enhancement with different CMR sequences, the standardized CMR protocol for assessment of IMH is not yet well established. The aim of this review is to evaluate the available literature on this issue, with particular regard to CMR sequences. New techniques, such as positron emission tomography/magnetic resonance imaging (PET/MRI), could be useful tools to explore molecular mechanisms of the myocardial infarction healing process.