Document Detail


MRI of acute myocarditis: a comprehensive approach based on various imaging sequences.
MedLine Citation:
PMID:  12426265     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jean-Pierre Laissy; Benoît Messin; Olivier Varenne; Bernard Iung; Daniel Karila-Cohen; Elisabeth Schouman-Claeys; P Gabriel Steg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  122     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-11-11     Completed Date:  2002-12-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1638-48     Citation Subset:  AIM; IM    
Affiliation:
Departments of Radiology, Hôpital Bichat, Paris, France. jean-pierre.laissy@bch.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Female
Humans
Magnetic Resonance Imaging* / methods
Male
Middle Aged
Myocarditis / pathology*
Prospective Studies

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