Diagnosis of cardiac sarcoidosis and evaluation of the effects of steroid therapy by gadolinium-DTPA-enhanced magnetic resonance imaging.
BACKGROUND
Cardiac involvement is an important prognostic factor in patients with sarcoidosis. In this study, we evaluated the usefulness of gadolinium-DTPA (diethylene triamine pentaacetic acid)-enhanced magnetic resonance imaging (Gd-MRI) for diagnosing cardiac sarcoidosis and evaluating the effects of steroid therapy.


METHODS
Sixteen patients with sarcoidosis diagnosed by histology or by Japanese Ministry of Health and Welfare criteria for cardiac sarcoidosis underwent Gd-MRI with a 1.5-Tesla superconducting magnet system using a T1-weighted spin-echo sequence.


RESULTS
Gd-MRI showed localized enhancement of signal intensity, indicating interstitial edema, in the left ventricle in 8 of the 16 patients. Two patients with enhancement also had thinning of the left ventricular septal wall. After 1 month of prednisolone therapy (60 mg every other day or 30 to 40 mg every day), the localized high-intensity signals were markedly diminished in all 8 patients.


CONCLUSIONS
Images of the heart obtained by Gd-MRI may reflect active inflammation with interstitial edema in patients with sarcoidosis. Gd-MRI may be a useful noninvasive method for early detection of cardiac sarcoidosis and for evaluating the effects of steroid therapy.
Shimada
T
T
Department of Internal Medicine, Cardiovascular Division, Shimane Medical University, Shimane, Japan.
Shimada
K
K
Sakane
T
T
Ochiai
K
K
Tsukihashi
H
H
Fukui
M
M
Inoue
S
S
Katoh
H
H
Murakami
Y
Y
Ishibashi
Y
Y
Maruyama
R
R
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use*; D012507:Sarcoidosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology
D000893:Anti-Inflammatory Agents; D003287:Contrast Media; D011239:Prednisolone; D019786:Gadolinium DTPA