title: Edema and fibrosis imaging by cardiovascular magnetic resonance: how can the experience of Cardiology be best utilized in rheumatological practice?
abstract: OBJECTIVE
  CMR, a non-invasive, non-radiating technique can detect myocardial oedema and fibrosis.
  
  
  METHODS
  CMR imaging, using T2-weighted and T1-weighted gadolinium enhanced images, has been successfully used in Cardiology to detect myocarditis, myocardial infarction and various cardiomyopathies.
  
  
  RESULTS
  Transmitting this experience from Cardiology into Rheumatology may be of important value because: (a) heart involvement with atypical clinical presentation is common in autoimmune connective tissue diseases (CTDs). (b) CMR can reliably and reproducibly detect early myocardial tissue changes. (c) CMR can identify disease acuity and detect various patterns of heart involvement in CTDs, including myocarditis, myocardial infarction and diffuse vasculitis. (d) CMR can assess heart lesion severity and aid therapeutic decisions in CTDs.
  
  
  CONCLUSIONS
  The CMR experience, transferred from Cardiology into Rheumatology, may facilitate early and accurate diagnosis of heart involvement in these diseases and potentially targeted heart treatment.
authors.affiliation: Onassis Cardiac Surgery Center, Athens, Greece. Electronic address: soma13@otenet.gr.
authors.forename: Sophie
authors.initials: S
authors.lastname: Mavrogeni
authors.affiliation: First Department of Propeudeutic and Internal medicine, Laikon Hospital, Athens University Medical School, Athens, Greece.
authors.forename: Petros
authors.initials: P
authors.lastname: Sfikakis
authors.affiliation: Department of Rheumatology, Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, West Midlands, UK.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Dimitroulas
authors.affiliation: Onassis Cardiac Surgery Center, Athens, Greece.
authors.forename: Genovefa
authors.initials: G
authors.lastname: Kolovou
authors.affiliation: Department of Rheumatology, Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, West Midlands, UK; Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester, UK.
authors.forename: George D
authors.initials: GD
authors.lastname: Kitas
mesh_terms: D003952:Diagnostic Imaging; D004489:Edema, Cardiac / Q000473:pathology*; D005355:Fibrosis / Q000473:pathology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D017202:Myocardial Ischemia / Q000473:pathology*; D009205:Myocarditis / Q000473:pathology*; D009206:Myocardium / Q000473:pathology*; D012219:Rheumatology
keywords: Autoimmune diseases; Cardiovascular magnetic resonance; Edema; Fibrosis; Myocardial infarction; Myocarditis; Vasculitis