[Cardiac MRI in suspected myocarditis].
OBJECTIVE
To evaluate the potential of ECG-gated breath-hold MRI in diagnosing acute myocarditis.


METHODS
Cardiac MRI was performed on 21 consecutive patients with suspected myocarditis. ECG-gated breath-hold T2-weighted images with fat suppression were acquired in 3 standard views. T1-weighted imaging (FLASH) was performed 10 min after IV administration of Gd-DTPA. Laboratory data included creatine kinase, troponin T and serological tests, ECG findings and echocardiography. Imaging findings were retrospectively compared to the discharge diagnoses. Signal alterations were semiquantitatively classified.


RESULTS
Acute myocarditis was diagnosed in 9 patients and cardiac sarcoidosis in 2 patients. Late enhancement was observed in 4 patients with acute myocarditis and in both patients with cardiac sarcoidosis. Semiquantitative evaluation revealed 9 true positive, 9 true negative, 1 false positive and 2 false negative results.


CONCLUSIONS
Cardiac MRI has the potential to detect acute myocarditis and to diagnose cardiac sarcoidosis. Late enhancement of Gd-DTPA can be found in both viral myocarditis and cardiac sarcoidosis.
Rieker
O
O
Klinik für Radiologie der Johannes Gutenberg-Universität Mainz, Germany. rieker@radiologie.klinik.uni-mainz.de
Mohrs
O
O
Oberholzer
K
K
Kreitner
K F
KF
Thelen
M
M
D000208:Acute Disease; D000328:Adult; D009202:Cardiomyopathies / Q000175:diagnosis*; D004796:Clinical Enzyme Tests; D003287:Contrast Media; D003402:Creatine Kinase / Q000097:blood; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009205:Myocarditis / Q000175:diagnosis*; D012507:Sarcoidosis / Q000175:diagnosis*; D020107:Troponin T / Q000097:blood
D003287:Contrast Media; D020107:Troponin T; D003402:Creatine Kinase; D019786:Gadolinium DTPA