Cardiac magnetic resonance (CMR) for the diagnosis of acute myocarditis (AM): Comparison between single-dose 1M gadobutrol (Gadovist®) and double-dose 0.5M gadolinium-DTPA (Magnevist®) in the detection of late enhancement (LE)

Congress:

ECR 2010

Poster Number:

C-0736

Type:

Scientific Exhibit

Keywords:

Cardiac, MR

Authors:

A. Esposito, F. De Cobelli, C. Sallemi, S. Ravelli, A. Del Maschio; Milan/IT

DOI:

10.1594/ecr2010/C-0736

DOI-Link:

https://dx.doi.org/10.1594/ecr2010/C-0736

Fig. 1: Late enhancement: long-axis two-chamber view. In the apical segment of...

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Fig. 5: Patient n°1: pattern of late enhancement typical of myocarditis involving left...

Fig. 6: Patient n°3: four-chamber long axis view. Comparison between (a)...

Purpose

BackgroundCardiac Magnetic Resonance (CMR) has an established role in the diagnosis and the follow-up of acute myocarditis (AM)and its subsequent stages, withlate enhancementtechnique as effective tool to assessthe myocardial damage typical of AM1-2.Some studies compared different contrast media in late gadolinium enhancement (LE) imaging for the assessment of acute or chronic myocardial injury3-4-5-6-7 but no data are available about the comparison between conventional 0.5M gadolinium-based contrast agent (Gd-CA) and new 1M Gd-CA in this technique.Conventional 0.5M gadolinium-based contrast-agents are commonly used at double-dose (0.2mmol/kg) to...

Methods and Materials

Seven patients with AM and a typical pattern of LE at a first CMR study performed for clinical reasons with the intravenous injection of 0.2mmol/kg of Magnevist® (Bayer-Schering Pharma), were enrolled in the study and underwent a second CMR study with acquisition of LE sequences after the i.v. injection of0.1mmol/kg of Gadovist® 1M (Bayer-Schering Pharma).Both CMR studies were performed on the same 1.5T magnet (Achieva;Philips) with a mean time interval of 67 hours.LE images were obtained in the short- and long-axisviews using 3D-T1w-IRTFE sequence, adjusting...

Results

Inversion time: The inversion time (IT) used to obtain perfect suppression of signal of normal myocardium in the LE images acquired after the injection of Gadovist, ranged from 240 to 350 ms, with a mean value ± SD =301 ± 38 ms.Single-dose Gadovist vs double-dose Magnevist:LE-volume(Magnevist 20,5 ± 23,7 cm3 vs Gadovist 20,6 ± 24,3 cm3), LE% (Magnevist18%±14% vs Gadovist17%±14%), SNR (Magnevist143±101 vs Gadovist123±60) and CNR (Magnevist104±74 vs Gadovist93±39) were not significantly different between Magnevist and Gadovist (all values p=n.s.).MagnevistGadovistp= n.s.LE-vol (cm3)20,5±23,720,6±24,3LE %18%±14%17%±14%SNR143±101123±60CNR104±7493±39IQ1,9±0,72±0,8DC1,3±0,51,4±0,5Location and distribution...

Conclusion

In the settingof acute myocarditis, LE images obtained with single-dose of Gadovist® are completely comparable to LE images obtained with double-dose of Magnevist®.

References

1) Shehata ML, Turkbey EB, Vogel-Claussen J, Bluemke DA.Role of cardiac magnetic resonance imaging in assessment of nonischemic cardiomyopathies.Top Magn Reson Imaging. 20082) Camastra GS, Cacciotti L, Marconi F, Sbarbati S, Pironi B, Ansalone G.Late enhancement detected by cardiac magnetic resonance imaging in acute myocarditis mimicking acute myocardial infarction: location patterns and lack of correlation with systolic function. J Cardiovasc Med 2007.3)Krombach GA, Hahnen C, Lodemann KP, Krämer N, Schoth F, Neizel M, Boeringer J, Günther RW, Kelm M, Kühl H.Gd-BOPTA for assessment of myocardial...

Personal Information

Dott. Antonio EspositoSan Raffaele Scientific Institutee-mail: [email protected]