Facharzt FMH Radiologie Practice Questions - Facharzt FMH Für Radiologie Spécialiste FMH En Radiologie Exam

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A 58-year-old man with a history of anterior ST-elevation myocardial infarction 6 months ago undergoes cardiac magnetic resonance (CMR) imaging to evaluate myocardial viability prior to revascularization. Late gadolinium enhancement (LGE) imaging demonstrates transmural enhancement involving >75% of the wall thickness in the mid-to-apical anterior and anteroseptal segments. How does this finding translate into the likelihood of functional myocardial recovery following coronary revascularization?

The likelihood of functional recovery is extremely low (<10-15%), as >75% transmural LGE reflects irreversible scar tissue and complete loss of functional reserve The likelihood of recovery is high (>80%), because transmural LGE indicates hyperemic viable myocardium with preserved metabolic reserve Transmural LGE indicates reversible myocardial stunning that will rapidly normalize within 48 hours post-angioplasty The degree of LGE transmurality cannot predict functional recovery; only end-diastolic wall thickness <5.5 mm indicates non-viability

Correct Answer:

The likelihood of functional recovery is extremely low (<10-15%), as >75% transmural LGE reflects irreversible scar tissue and complete loss of functional reserve

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