Multimodality Imaging Assessment of Myocardial Fibrosis

Highlights

• Myocardial fibrosis can manifest as focal replacement or diffuse interstitial fibrosis.

• Multimodality imaging of myocardial fibrosis can be direct or indirect and includes use of cardiac magnetic resonance, computed tomography, and nuclear imaging.

• Understanding the roles and limitations of each imaging modality is critical for test selection.

Abstract

Myocardial fibrosis, seen in ischemic and nonischemic cardiomyopathies, is associated with adverse cardiac outcomes. Noninvasive imaging plays a key role in early identification and quantification of myocardial fibrosis with the use of an expanding array of techniques including cardiac magnetic resonance, computed tomography, and nuclear imaging. This review discusses currently available noninvasive imaging techniques, provides insights into their strengths and limitations, and examines novel developments that will affect the future of noninvasive imaging of myocardial fibrosis.