A New Radiological Sign: “Transmural Stria of Cabrales”, a Marker for the Detection of Acute Myocardial Infarction

Abstract

Introduction: Acute myocardial infarction is one of the leading causes of cardiovascular mortality and morbidity worldwide, representing a significant clinical and healthcare challenge.

Objective: To describe the Transmural Streak Sign, a novel radiological finding on contrast-enhanced computed tomography associated with acute myocardial infarction.

Methods: A descriptive observational study was conducted in 45 patients with confirmed Acute myocardial infarction. Contrast-enhanced computed tomography images were analyzed to identify the presence of the sign, quantifying its attenuation in Hounsfield units and correlating it with angiographic findings and biomarkers.

Results: The sign was identified in 71% of patients. The hypodense linear band showed a mean attenuation of 26.4 ± 4.8 HU, significantly lower than healthy myocardium (85.7 ± 12.3 HU) (p < 0.001). It was correlated with infarct location and troponin levels (r = 0.68, p = 0.003).

Conclusions: The sign is a reproducible and specific radiological marker for ischemic transmural necrosis on computed tomography, with the potential to improve early detection of acute myocardial infarction, even in non-specific cardiac studies.