MRI of Acute Myocarditis
Autor: | P. Gabriel Steg, Daniel Karila-Cohen, Jean-Pierre Laissy, Elisabeth Schouman-Claeys, Olivier Varenne, Bernard Iung, Benoît Messin |
---|---|
Rok vydání: | 2002 |
Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Myocarditis medicine.diagnostic_test business.industry Subtraction Magnetic resonance imaging Critical Care and Intensive Care Medicine Control subjects medicine.disease Precontrast Acute myocarditis medicine Medical imaging Radiology Cardiology and Cardiovascular Medicine Nuclear medicine business Early phase |
Zdroj: | Chest. 122:1638-1648 |
ISSN: | 0012-3692 |
DOI: | 10.1378/chest.122.5.1638 |
Popis: | 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% ŷ 3.2% in patients, vs 29% ŷ 3.1% in control subjects using T1-weighted MRI (p 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. |
Databáze: | OpenAIRE |
Externí odkaz: |