title: Cardiac magnetic resonance visualizes acute and chronic myocardial injuries in myocarditis.
abstract: Our objective was to evaluate the ability of CMR to visualize myocardial injuries over the course of myocarditis. We studied 42 patients (39 males, 3 females; age 37 ± 14 years) with myocarditis during the acute phase and after 12 ± 9 months. CMR included function analyses, T2-weighted imaging (T2 ratio), T1-weighted imaging before and after i.v. gadolinium injection (global relative enhancement; gRE), and late gadolinium enhancement (LGE). In the acute phase, the T2 ratio was elevated in 57%, gRE in 31%, and LGE was present in 64% of the patients. In 32 patients (76%) were any two (or more) out of three sequences abnormal. At follow-up, there was an increase in ejection fraction (57.4 ± 11.9% vs. 61.4 ± 7.6; P < 0.05) while both T2 ratio (2.04 ± 0.32 vs. 1.70 ± 0.28; P < 0.001) and gRE (4.07 ± 1.63 vs. 3.11 ± 1.22; P < 0.05) significantly decreased. The LGE persisted in 10 patients. Dilated cardiomyopathy was present in 3 patients and 4 patients received a defibrillator or a pacemaker. A comprehensive CMR approach is a useful tool to visualize myocardial tissue injuries over the course of myocarditis. CMR may help to differentiate acute from healed myocarditis, and add information for the differential diagnoses.
authors.affiliation: Department of Radiology, Oslo University Hospital, Ullevaal, Oslo, Norway. k.h.stensath@medisin.uio.no
authors.forename: Knut Haakon
authors.initials: KH
authors.lastname: Stensaeth
authors.forename: Pavel
authors.initials: P
authors.lastname: Hoffmann
authors.forename: Eigil
authors.initials: E
authors.lastname: Fossum
authors.forename: Arild
authors.initials: A
authors.lastname: Mangschau
authors.forename: Leiv
authors.initials: L
authors.lastname: Sandvik
authors.forename: Nils Einar
authors.initials: NE
authors.lastname: Klow
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology*; D009664:Norway; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D013318:Stroke Volume; D013997:Time Factors; D016277:Ventricular Function, Left; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA