Diagnostic value of ECG-gated multidetector computed tomography in the early phase of suspected acute myocarditis. A preliminary comparative study with cardiac MRI.
The aim of the study was to determine the potential diagnostic value of contrast-enhanced echocardiogram (ECG)-gated multidetector computed tomography (MDCT) in the setting of suspected acute myocarditis compared with contrast-enhanced magnetic resonance imaging (MRI). The study group consisted of 12 consecutive patients admitted for suspected acute myocarditis less than 10 days after onset of symptoms. All patients had clinical, electrocardiographic signs, and laboratory findings consistent with the diagnosis. All patients but one (severe claustrophobia) underwent cardiac MRI using T1-weighted delayed-enhancement images after injection of gadolinium. ECG-gated MDCT was performed in all patients and included a first-pass contrast-enhanced acquisition and a delayed acquisition. MRI revealed abnormal focal or multifocal myocardial enhancement and confirmed the diagnosis in 11 patients. The first-pass MDCT acquisition showed homogenous left-ventricle contrast enhancement and absence of coronary stenosis in all patients. Delayed MDCT acquisition, performed 5 min later without reinjection of contrast medium revealed multiple areas of myocardial hyperenhancement in a focal or a multifocal pattern (six and six patients, respectively). Extent and location of hyperenhancement at MDCT correlated well with that observed at MR examination for all 11 patients evaluated by both techniques (r=0.9167, p=0.0004). These preliminary results show that ECG-gated MDCT could be a useful alternative noninvasive diagnostic test in the early phase of acute myocarditis.
Dambrin
Grégoire
G
Departments of Cardiology and Radiology, Centre Chirurgical Marie Lannelongue, 133 Avenue de la Résistance, 92350 Le Plessis Robinson, France.
Laissy
Jean Pierre
JP
Serfaty
Jean Michel
JM
Caussin
Christophe
C
Lancelin
Bernard
B
Paul
Jean François
JF
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002097:C-Reactive Protein / Q000378:metabolism; D003287:Contrast Media; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009205:Myocarditis / Q000000981:diagnostic imaging* / Q000473:pathology*; D012107:Research Design; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D019210:Troponin I / Q000097:blood
D003287:Contrast Media; D019210:Troponin I; D002097:C-Reactive Protein; D003402:Creatine Kinase; D019786:Gadolinium DTPA