Detection of myocarditis by contrast-enhanced MRI in patients presenting with acute coronary syndrome but no coronary stenosis

Autor: Michael Angioi, Gilles Karcher, Jacques Felblinger, Gerard Ethevenot, Pierre Y. Marie, Etienne Aliot, Wassila Djaballah, Nicolas Sadoul, A. Codreanu, Frédéric Moulin
Přispěvatelé: Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Risque cardiovasculaire, rigidité-fibrose et hypercoagulabilité (RCV), Université Henri Poincaré - Nancy 1 (UHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Radiologie [CHRU Nancy], Service de Médecine Nucléaire [Nancy], Felblinger, Jacques
Jazyk: angličtina
Rok vydání: 2007
Předmět:
Gadolinium DTPA
Male
MESH: Chi-Square Distribution
[INFO.INFO-IM] Computer Science [cs]/Medical Imaging
Contrast Media
030204 cardiovascular system & hematology
Coronary Angiography
Chest pain
030218 nuclear medicine & medical imaging
MESH: Magnetic Resonance Imaging
0302 clinical medicine
Prospective Studies
Myocardial infarction
Prospective cohort study
skin and connective tissue diseases
[INFO.INFO-BI] Computer Science [cs]/Bioinformatics [q-bio.QM]
MESH: Statistics
Nonparametric
Framingham Risk Score
[SDV.BIBS] Life Sciences [q-bio]/Quantitative Methods [q-bio.QM]
MESH: Middle Aged
MESH: Chest Pain
MESH: Technetium Tc 99m Sestamibi
Steady-state free precession imaging
Middle Aged
Magnetic Resonance Imaging
[SDV.BIBS]Life Sciences [q-bio]/Quantitative Methods [q-bio.QM]
3. Good health
C-Reactive Protein
myocardial infarction
Acute Disease
Cardiology
MESH: Acute Disease
Female
medicine.symptom
Perfusion
MESH: Radiopharmaceuticals
Technetium Tc 99m Sestamibi
Chest Pain
medicine.medical_specialty
Acute coronary syndrome
MESH: Troponin I
Myocarditis
MESH: Gadolinium DTPA
Statistics
Nonparametric
MESH: Tomography
Emission-Computed
Single-Photon
acute coronary syndrome
Diagnosis
Differential
03 medical and health sciences
MESH: Myocarditis
MESH: Diagnosis
Differential
Internal medicine
MESH: Contrast Media
MESH: C-Reactive Protein
medicine
cardiac MRI
[INFO.INFO-IM]Computer Science [cs]/Medical Imaging
Humans
Radiology
Nuclear Medicine and imaging
contrast-enhancement
Tomography
Emission-Computed
Single-Photon
Chi-Square Distribution
MESH: Humans
business.industry
Troponin I
medicine.disease
MESH: Male
MESH: Prospective Studies
MESH: Coronary Angiography
Radiopharmaceuticals
myocarditis
[INFO.INFO-BI]Computer Science [cs]/Bioinformatics [q-bio.QM]
business
MESH: Female
Zdroj: Journal of Magnetic Resonance Imaging
Journal of Magnetic Resonance Imaging, Wiley-Blackwell, 2007, 25 (5), pp.957-64. ⟨10.1002/jmri.20897⟩
ISSN: 1053-1807
1522-2586
DOI: 10.1002/jmri.20897⟩
Popis: Purpose To prospectively assess the use of cardiac MRI with delayed contrast enhancement (DCE) for identifying patients with active myocarditis among those presenting with acute coronary syndrome (ACS) but no coronary stenosis. Materials and Methods A total of 27 consecutive patients (age = 45 ± 17 years; 14 male) presenting with ACS (chest pain, positive troponin-I) and no coronary stenosis, underwent cardiac MRI 9 ± 7 days after pain onset and 8 ± 5 months later (N = 19). Steady-state free-precession pulse (SSFP) sequence was applied for the assessment of myocardial function and both inversion-recovery (IR) and SSFP sequences were used for analyzing the topography and extent of DCE areas. Rest sestamibi-gated-single photon emission CT (SPECT) was also systematically performed. Results Subepicardial DCE pattern typical of acute myocarditis was documented in 12 patients (44%). Ischemic DCE pattern (transmural or subendocardial focal DCE) was documented in 12 of the 15 remaining patients (44%). Patients with subepicardial DCE had: higher C-reactive protein (CRP) levels (38 ± 32 vs. 14 ± 24 mg/mL; P = 0.04), lower Framingham cardiovascular risk (3 ± 3% vs. 9 ± 5%; P < 0.001), lower incidence of perfusion SPECT defects (17% vs. 73%; P = 0.01), higher left ventricular (LV) end-diastolic volume (77 ± 16 vs. 64 ± 10 mL/m2; P = 0.02), and higher regression of DCE areas at follow-up (−65 ± 17% vs. −18 ± 23%; P = 0.002). Conclusion DCE pattern of active myocarditis can be seen in patients presenting with ACS but no coronary stenosis. J. Magn. Reson. Imaging 2007;25:957–964. © 2007 Wiley-Liss, Inc.
Databáze: OpenAIRE
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