Unusual Cause of Mid Myocardial Late Gadolinium Enhancement at Cardiac MRI

Radiol Cardiothorac Imaging. 2025 Feb;7(1):e240012. doi: 10.1148/ryct.240012.

Abstract

Cardiac MRI is the reference standard for identifying and evaluating myocardial pathologic conditions. Late gadolinium enhancement characteristics provide an excellent guide in classifying disease and triaging patients. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an uncommon congenital anomaly. Myocardial enhancement at cardiac MRI is often a sign of a myocardial pathologic condition, while more specifically, subendocardial enhancement is a feature expected in patients with ALCAPA. This report describes the atypical finding of mid myocardial late gadolinium enhancement in three adult patients with ALCAPA. Keywords: Mid Myocardial Enhancement, Cardiac MRI, Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery © RSNA, 2025.

Keywords: Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery; Cardiac MRI; Mid Myocardial Enhancement.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Contrast Media*
  • Coronary Vessel Anomalies / diagnostic imaging
  • Coronary Vessel Anomalies / pathology
  • Female
  • Gadolinium*
  • Humans
  • Image Enhancement / methods
  • Magnetic Resonance Imaging / methods
  • Magnetic Resonance Imaging, Cine / methods
  • Male
  • Middle Aged
  • Myocardium / pathology
  • Pulmonary Artery / abnormalities
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / pathology

Substances

  • Contrast Media
  • Gadolinium