title: MRI of cardiac sarcoidosis: basal and subepicardial localization of myocardial lesions and their effect on left ventricular function.
abstract: OBJECTIVE
  The objective of our study was to use MRI to analyze the topographic localization of myocardial lesions and their relationship to plasma brain natriuretic peptide (BNP) levels and several cardiac function parameters in patients with cardiac sarcoidosis.
  
  
  METHODS
  Delayed contrast-enhanced MRI was performed in 40 patients with sarcoidosis (11 cardiac, 29 extracardiac cases). Using a 29-segment model of the left ventricle (LV), the extent of myocardial hyperenhancement was visually scored (0 = no hyperenhancement, 1 = 1-25%, 2 = 26-50%, 3 = 51-75%, 4 = 76-100% hyperenhancement) and was compared with plasma BNP level and several parameters of cardiac function.
  
  
  RESULTS
  Ten of the 11 patients with cardiac sarcoidosis showed myocardial hyperenhancement, whereas none of the 29 patients without cardiac sarcoidosis did. In patients with cardiac sarcoidosis, hyperenhancement was significantly more extensive in basal short axis slices than in apical short axis slices (p < 0.0005). Myocardial hyperenhancement was significantly more frequent in subepicardial layers than in subendocardial layers. The global extent of myocardial hyperenhancement was significantly correlated with plasma BNP levels and the LV end-diastolic volume index and was negatively correlated with the LV ejection fraction.
  
  
  CONCLUSIONS
  In patients with cardiac sarcoidosis, myocardial lesions detected on delayed contrast-enhanced MRI were predominantly localized in the basal and subepicardial myocardium. The extent of myocardial lesions may be related to LV dysfunction and plasma BNP level in patients with cardiac sarcoidosis.
authors: Department of Radiology, Tohoku University Graduate School of Medicine, Seiryomachi, Aobaku, Sendai 980-8574, Japan. azusa@rad.med.tohoku.ac.jp
authors: Azusa
authors: A
authors: Ichinose
authors: Hiroki
authors: H
authors: Otani
authors: Minako
authors: M
authors: Oikawa
authors: Kei
authors: K
authors: Takase
authors: Haruo
authors: H
authors: Saito
authors: Hiroaki
authors: H
authors: Shimokawa
authors: Shoki
authors: S
authors: Takahashi
mesh_terms: D009202:Cardiomyopathies / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D015203:Reproducibility of Results; D012507:Sarcoidosis / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology
chemical_list: D020097:Natriuretic Peptide, Brain