Format

Send to

Choose Destination
Chest. 2002 Nov;122(5):1638-48.

MRI of acute myocarditis: a comprehensive approach based on various imaging sequences.

Author information

1
Departments of Radiology, Hôpital Bichat, Paris, France. jean-pierre.laissy@bch.ap-hop-paris.fr

Abstract

STUDY OBJECTIVES:

To explore the diagnostic performance of MRI for the diagnosis of acute myocarditis, using a comprehensive imaging approach.

DESIGN AND SETTINGS:

Twenty patients with myocarditis and 7 age-matched and gender-matched control subjects underwent comprehensive MRI. Magnetic resonance (MR) examinations included axial T2-weighted sequences, precontrast and postcontrast ECG-gated T1-weighted sequences in axial and short heart axis, cine-MRI, and serial dynamic turbo fast low-angle shot (turboFLASH) acquisitions in the short axis following Gd injection for a period of 2 min. Precontrast and postcontrast images were postprocessed using subtraction. Two observers read all images qualitatively and quantitatively. Myocardial enhancement was compared between patients and control subjects.

PATIENTS:

Myocardial involvement was focal in 6 patients examined within 1 week from clinical onset, and diffuse in the remaining 14 patients examined later.

RESULTS:

Qualitatively, contrast-enhanced T1-weighted subtracted images had 100% sensitivity and specificity for myocardial involvement. Postcontrast T1-weighted images were able to discriminate the early phase (nodular enhancement) from the later phase of myocarditis (diffuse enhancement). Quantitatively, myocardial enhancement was 56% +/- 3.2% in patients, vs 29% +/- 3.1% in control subjects using T1-weighted MRI (p < 0.0001). Serial turboFLASH images displayed greater myocardial enhancement between 25 s and 120 s in patients than in control subjects (p < 0.0001); however, there was marked enhancement of skeletal muscles in both early and late stages of myocarditis compared to control subjects (p < 0.0001).

CONCLUSION:

On the basis of subtracted cardiac-gated T1-weighted images and serial postinjection turboFLASH images, our study shows that myocarditis is largely, at least in the early stages, a focal process in the myocardium. It also provides evidence of transient skeletal muscle involvement, which may actually be useful for diagnosis.

PMID:
12426265
DOI:
10.1378/chest.122.5.1638
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center