The National Institute of Health defined
cardiomyopathy as diseases of the heart muscle. These
myocardial diseases have different etiology, structure and treatment. This review highlights the key imaging features of different
myocardial diseases. It provides information on myocardial structure/orientation, perfusion, function and viability in diseases related to
cardiomyopathy. The standard cardiac magnetic resonance imaging (MRI) sequences can reveal insight on left ventricular (LV) mass, volumes and regional contractile function in all types of
cardiomyopathy diseases. Contrast enhanced MRI sequences allow visualization of different
infarct patterns and sizes. Enhancement of myocardial
inflammation and
infarct (location, transmurality and pattern) on contrast enhanced MRI have been used to highlight the key differences in
myocardial diseases, predict recovery of function and healing. The common feature in many forms of
cardiomyopathy is the presence of diffuse-
fibrosis. Currently, imaging sequences generating the most interest in
cardiomyopathy include myocardial strain analysis, tissue mapping (T1, T2, T2*) and extracellular volume (ECV) estimation techniques. MRI sequences have the potential to decode the etiology by showing various patterns of
infarct and diffuse
fibrosis in
myocarditis,
amyloidosis,
sarcoidosis,
hypertrophic cardiomyopathy due to
aortic stenosis,
restrictive cardiomyopathy, arrythmogenic right ventricular dysplasia and
hypertension. Integrated PET/MRI system may add in the future more information for the diagnosis and progression of
cardiomyopathy diseases. With the promise of high spatial/temporal resolution and 3D coverage, MRI will be an indispensible tool in diagnosis and monitoring the benefits of new
therapies designed to treat
myocardial diseases.