 First, many junior resident from SMS Medical College, Jaipur Rajasthan. Thank you, MRI teaching course for this opportunity to present my research article on the delayed cardiac shimmering, the role of cardiac late gadolinium enhancement pattern in cardiac MRI. The notion of late myocardial enhancement in contrast enhanced cardiac MR is currently being used to evaluate the myocardial viability. The area of accumulation of the gadolinium-based contrast agents in the tissue reflects irrevocable damage after the chronic myocardial infarction. Many studies have proven this technique to be feasible just opposed with other methods and with regard to the outcome after re-vascularization in the cardiac coronary artery disease. Whereas late gadolinium enhancement is very sensitive in the characterizing myocardial scarring, though not specific to the ischemic damage, since gadolinium dilumine generally accumulates in the tissue with increased water content. Thus, late gadolinium enhancement usually occurs in myocardial areas of fibroxes, edema, and intramission, where the volume of extracellular component has increased. Different myocardial disorders can be distinguished from ischemic based on the pattern and the localization of the LG in the contrast enhanced MRI. Purpose of the study is to evaluate the role of late gadolinium enhancement pattern in differentiating ischemic from the non-ischemic cardiac disease to study the role of late gadolinium enhancement imaging in differentiating viable from the non-viable myocardium in ischemic heart disease and identifying potential complications of myocardial infarction. Our study included 39 patients who were referred from the Cardiology Department to the Department of Credit diagnosis for ECG-Gated multi-parametric contrast enhanced MRI cardiac MRI workup using the Philips Ingenia 3 Tesla MRI scanner with dedicated protocol involving the Turbospinico gradient eco dynamics in imaging using steady state free precision sequence sort of inversion recovery sequences for edema imaging, delayed gadolinium enhancement sequences using phase sensitive inversion recovery sequences 10 minutes after the contrast injection. Patients who had late gadolinium enhancement were included in our study. All datasets with LG after the contrast were reviewed and extend that is subendocardial mid myocardial subepicardial transmural and pattern that is area intensity and distribution were evaluated. Left ventricular LG was described according to the American Heart Association 17 second model. In all patients the history of myocardial infarction and geographically proven coronary artery disease with coronary distribution of LG ischemic pattern was suspected which were reviewed in the post-contrast images. However, those in which angiographically excluded CAD or no history of MRI MRI, LG of the non-schemic pattern was suspected. Final diagnosis was reached on the basis of clinical features, appropriate blood investigation, ECG, echocardiography and cardiac MR. Our study included 39 patients of the age of 36 years in which 27 were male and 12 were females. Most common presenting symptom was chest pain followed by breathlessness and palpitation. The most common comorbidity was hypertension followed by diabetes and high hypothyroidism. Those with ischemic patterns SCAR were 24 and which is 62% of the total cases and 38% of the total cases were included in the non-schemic pattern in the pie chart. The paragraph shows the vascular data involvement. The most common vascular data involved was LAD. The transmitter was SCAR was seen in 8 out of 24 patients of the ischemic group. SCAR score allotted to the left and right according to the 72nd model range from 18 to 43 and was found to be more in cases of comorbidities like hypertension and diabetes. Transmirality index had reached from 3 to 9 which is a predictor of reversibility after revascularization. Greater than the transmirality index, poorage of the prognosis for recovery of myocardial contractility after treatment. Microscope section of no reflow phenomenon was seen in 8 out of 24 patients of the ischemic group which indicates severe ischemic disease and is associated with poorer prognosis, adverse cardiovascular events and adverse ventricular remodelling. Coming to the first case is a 33 year old male with a history of coronary artery disease. Image A is the vertical long axis cineimage of the balance turbofuel eco showing extensive thinning of the anterior wall of the ventricle extending from the mid to apex of the left ventricle. The PNC which is a post contrast late cadolinium enhancement images showing sub-bendocardial to mid myocardial SCAR from the mid to distal left ventricle and the C image shows a low signal linear area in the left ventricular wall suggesting microvascular obstruction. Second case is a 59 year old male who was a angiographically diagnosed coronary artery disease was referred for viability study. Image A is the vertical short axis image which is a star image showing the myocardial edema. B and C images are the post contrast gadolinium enhancement images which are showing sub endocardial to mid myocardial SCAR which is extending up to the apex and there is a low signal area in the left ventricular wall suggesting microvascular obstruction. Among the 15 non ischemic group following other cases which is showing the late cadolinium enhancement. We had a three cases of myocarditis, four cases of pericarditis, two cases of sapodosis, one case is of myodosis, dilated cardamomipathy, SCAR myocardium due to congenital heart disease and three cases of hypertrophic cardamomipathy. These are different patterns of specific which are specific for the non ischemic late cadolinium enhancement patterns in our cases. This is the first case in the non ischemic group which is a 66, 65 year old male with the symptoms of cardiac failure shows the diastolic frames of silly images of the vertical long axis, horizontal long axis and the short axis images showing thickened LV with suboptimal lulling of the left hand like the myocardium with mild pericardial effusion and the pylate and plural effusion. This is the late cadolinium enhancement images showing the global sub endocardial patchy mid myocardium in a non coronary artery distribution suggesting non ischemic LT which is turned out to be cardiac amyloidosis after the fat pad biopsy which revealed the cardiac which revealed the amyloidosis. This is strain echocardiography which was done after the MR diagnosis showed there is sparing of the apex with involvement of the base. For 66 year old female with history of acute effusive constructive pericarditis is cardiac failure on collagen treatment and with cardiac MRI for recurrence of the cut chest pain since one month image is a star image which is showing no high signal intensity suggesting absence of myocardial edema suggesting it is a chronic event and B and C which is the post cadolinium enhancement images showing there is circumferential pericardial enhancement more marked along the right ventricular free wall suggesting chronic pericarditis. The 55 year old female with suspected history of cardiac amyloidosis underwent cardiac MRI A and B images are the showing the severe left ventricular atrial enlargement with small size delve cavity with thickened basal to mid interventricular septum and anterior LV free wall with systolic obliteration of the left ventricular captain apical ballooning with thinned out left ventricular wall and left ventricular apex. C and C images the post contrast image showing there is a thickened portion of the myocardium showing this car. So 46 year old male who is a known case of severe valvular PS with recurrent apical ventricular tachycardia was the underwent cardiac MRI to look for the focus of arrhythmia. There was a dilated and evaporated left ventricular wall with late carolinium enhancement seen in the right ventricular free wall. Conclusion late carolinium enhancement is a contrast enhanced cardiac MRI is not specific for the ischemic infarction. LG in ischemia almost always involves a ventricular layer where it does not necessarily seen in the other myocardial diseases. Therefore if the LG excludes a ventricular layer non ischemic myocardial diseases must be considered as treatment protocol differs in this both patterns. The specific pattern of late carolinium enhancement is to identify different myocardial myopericardial diseases and thereby helping the clinicians to appropriate management. These are my references. Thank you.