Contrast Media–Enhanced Magnetic Resonance Imaging Visualizes Myocardial Changes in the Course of Viral Myocarditis

Abstract

Acute myocarditis evolves from a focal to a disseminated process during the first 2 weeks after onset of symptoms. Contrast media-enhanced MRI visualizes the localization, activity, and extent of inflammation and may serve as a powerful noninvasive diagnostic tool in acute myocarditis.

T1, T2 Mapping and Extracellular Volume Fraction (ECV): Application, Value and Further Perspectives in Myocardial Inflammation and Cardiomyopathies

“…For example Troponin T is only present in 35 -45 % biopsy-proven myocarditis caese [21]. Regional and global wall motion abnormalities are common in myocarditis [22]. Otherwise cardiac dysfunction is not specific for myocardial inflammation and its sensitivity is limited [23,24].…”

Detection of myocarditis by contrast‐enhanced MRI in patients presenting with acute coronary syndrome but no coronary stenosis

“…This observation strongly supports the need for accurate identification and specific medical management of these patients. LV dilatation is frequently documented in the course of myocarditis (4,19,20,36) and increasing evidence exists concerning a possible progression to dilated cardiomyopathy (41). Further long-term follow-up studies in larger groups will be required to define the prognostic significance of these observations.…”

“…DCE identifies acute or chronic myocardial infarction even when restricted to small subendocardial areas (17,18). MRI with hyperenhancement gadolinium-tracer analysis has also been successfully applied in identifying myocarditis, either by using a nonbreathhold T1-weighted spin-echo pulse sequence (19), or the newer inversion-recovery gradient-echo pulse (IR-GRE) sequences dedicated to DCE analysis (20,21). In this setting, the DCE areas are commonly documented in the subepicardial layers of the left ventricle, close to the pericardium, especially on the lateral wall (20).…”

Diagnostic Performance of Multisequential Cardiac Magnetic Resonance Imaging in Acute Cardiac Allograft Rejection

“…Two important features discriminating moderate acute cellular rejection from lesser grades are the presence of multiple areas of myocardial necrosis as well as myocardial oedema. Cardiac magnetic resonance imaging (CMR) has been demonstrated in prior studies to identify both these features in the non-transplant population, 10,11 with at least one study also demonstrating increased myocardial oedema in acute cardiac allograft rejection. 12 Furthermore, multisequential CMR is an established non-invasive investigation for the diagnosis of acute myocarditis, 13 a condition that has some histological similarity to acute cellular rejection.…”