Figure 3

Axial (a) and short axis (b) first pass perfusion SSFP MR images demonstrate a large area of microvascular obstruction in the inferolateral and inferoseptal left ventricular wall (arrowheads) with an area of blister-like contrast pouch covered by a 1 mm thin rim of infarcted myocardial tissue (arrow) compatible with an impending left ventricular rupture. The magnified view (c, the area is indicated by the square in Fig. 3a) of an axial T1 weighted double inversion FSE MR image confirms the thin myocardial cover (arrow) of this subepicardial aneurysm (arrow), which has bright signal due to slower flow compared to the left ventricular blood pool. The overlying epicardial fat (arrowhead) and pericardium are normal. Figure 3d represents a drawing of the complex anatomy in figure 3c.