Assessment of myocardial fibrosis using T1-mapping and extracellular volume measurement on cardiac magnetic resonance imaging for the diagnosis of radiation-induced cardiomyopathy
| Autor: | Yasutoshi Ohta, Toshihide Ogawa, Hatsue Ishibashi-Ueda, Nobuhiko Haruki, Yoshiharu Kinugasa, Toshihiko Akasaka, Kazuhiro Yamamoto, Masahiko Kato, Natsuko Mukai-Yatagai |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Constrictive pericarditis
medicine.medical_specialty Side effect Heart disease medicine.diagnostic_test business.industry Diastole Cardiomyopathy 030204 cardiovascular system & hematology Esophageal cancer medicine.disease Article 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Cardiac magnetic resonance imaging Internal medicine medicine Cardiology Myocardial fibrosis Cardiology and Cardiovascular Medicine business |
| Popis: | Radiation-induced heart disease (RIHD) is a serious side effect of thoracic radiation therapy (RT) and is associated with significant morbidity and mortality. Radiation-induced cardiomyopathy (RICM) is one of the manifestations of RIHD, which represents with left ventricular (LV) systolic and diastolic dysfunction due to myocardial fibrosis. Although the diagnosis of RIHD is challenging and is generally an exclusion diagnosis, multimodality imaging including echocardiography, cardiac computed tomography and cardiac magnetic resonance (CMR) imaging could help the diagnosis. Herein, we report a case of 70-years-old male, who had been treated with chemo-radiation therapy for early esophageal cancer, was suffered from medically refractory heart failure due to severely reduced LV systolic function and constrictive pericarditis 8 years after chemo-radiation therapy. Although no gadolinium-enhancement (LGE) was detected on CMR, T1 mapping depicted increased extracellular matrix volumes of 45%, which suggested global myocardial fibrosis. Histopathological analysis by endomyocardial biopsy (EBM) revealed marked degeneration of myocytes and interstitial fibrosis, while vacuolation in myocytes which is characteristics of chemotherapy induced cardiomyopathy was not specific by electron microscopy. Therefore, we diagnosed that the present case was likely to the RICM. |
| Databáze: | OpenAIRE |
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