Learning objectives
The objective of this study is to present a brief review of the role of cardiac MRI in the diagnosis of myocarditis.
Background
Myocarditis isdefined asan inflammatory processaffectingthe myocardium.It is believed that the disease developsfrompathologicalautoimmune responseand viral infections.
Its courseis usuallyasymptomaticor insidious,
withconsiderable difficultyin establishing the diagnosis,
because ofitsnonspecificclinical presentationand the low sensitivityofadditional tests.
It is a clinical entity that is characterized by inflammatory infiltrates in the myocardium,
with varying degrees of myocyte necrosis and engages adjacent parenchyma and interstitium of acutely or chronically.
From the standpoint of topographical distribution of the inflammatory process,
the infectious myocarditis may be focal,
localized or diffuse.
Histopathologically,
it is classified as...
Imaging findings OR Procedure details
The main techniques of cardiac magnetic resonance (CMR) and findings in the diagnosis of myocarditis.
The cardiac MRI can target for diagnosis of myocarditis mainly by two techniques.
The first focused on the research of the inflammatory process,
uses s T1 and T2 weighted imagethat can demonstrate increased signal intensity so early after contrast administration,
allowing even monitor the inflammation in the myocardium.
The second technique uses the delayed enhancement,
being performed ten to fifteen minutes after contrast administration,
which evaluates areas of necrosis and...
Conclusion
It is possible to consider MRI the method of choice for the diagnosis and management of patients with clinically suspected myocarditis.
The pattern of patch late enhancement in CMR localized in meso and subepicardial areas are highly sensitivity and specific for the diagnosis of myocarditis.
The multifocal pattern of delayed enhancement along with increased signal on MRI,
especially in the acute phase of the disease,
shows high rates of specificity and sensitivity,
and can be considered as the method of choice for diagnosis and follow-up...
References
Abdel-Aty,
H; Boye,
P; Zagrosek,
A et al.
Diagnostic performance of cardiovascular magnetic resonance in patients with suspected acute myocarditis: comparison of different approaches.
J Am Coll Cardiol.; 45:1815-1822,
2005.
Al-Amoodi,
M; Rao,
K; Rao,
S; Brewer,
JH et al.
Fulminant Myocarditis Due to H1N1 Influenza.
Circ Heart Fail.;3:e7-e9,
2010.
ALMEIDA,
AR; LOPES,
LR; DUARTE,
S; MIRANDA,
R et al.
The importance of cardiac MRI in the diagnosis of myocarditis - clinical case.
Rev Port Cardiol.;29(07-08):1261-1268,
2010.
AMABILE,
N; FRAISSE,
A; BOUVENOT,
J et al....