Aims and objectives
Cardiac magnetic resonance (CMR) has an exclusive role in the noninvasive detection of myocardial inflammation.
Late gadolinium enhancement (LGE) imaging has a high sensitivity for the detection of fibrous tissue,
commonly found in myocarditis.
In acute myocarditis,
the presence of myocardial fibrosis has diagnostic and prognostic value.
Therefore,
LGE imaging has become a key evaluation tool in the difficult diagnosis of this disease.
Long acquisition times are a big drawback of CMR,
so optimization of imaging protocols is compelling for patient benefit and for an...
Methods and materials
Short axis 2D LGE and 3D LGE sequences (same spatial resolution of 1.2 x 1.2 mm²; slice- thickness 8 mm; field of view,
350 x 350 mm²) were acquired in 30 patients with epicardial and midmyocardial scars (12 female,
mean age 37.5 ± 16 years) at a 1.5T clinical scanner (Achieva,
Philips,
Best,
the Netherlands).
Image quality was evaluated by two independent,
blinded readers using a 5-point Likert scale,
ranging from excellent (score: 1) to nondiagnostic (score: 5).
Myocardial and fibrotic mass as well as...
Results
For 21 of 30 (70%) of the 3D data sets and 22 of 30 (73.3%) of the 2D data sets,
image quality was excellent (score: 1).
Poor (score: 4) and nondiagnostic (score: 5) image quality was not found in either group.
There was no significant difference in image quality between 3D und 2D LGE acquisitions (1.5 vs 1.4,
P = 0.3) with good interreader agreement (weighted κ = 0.7 vs.
0.6).
There were no significant differences between 3D and 2D LGE acquisitions for myocardial mass...
Conclusion
In patients with myocarditis 3D LGE imaging shows equal diagnostic quality and scar visibility compared to clinically established 2D LGE sequences but with a significantly reduced acquisition time.
References
Friedrich MG,
Sechtem U,
Schulz-Menger J et al (2009) Cardiovascular magnetic resonance in myocarditis: A JACC White Paper.
J Am Coll Cardiol 53:1475-1487
Korkusuz H,
Esters P,
Huebner F,
Bug R,
Ackermann H,
Vogl TJ (2010) Accuracy of cardiovascular magnetic resonance in myocarditis: comparison of MR and histological findings in an animal model.
J Cardiovasc Magn Reson 12:49
Ammirati E,
Moroni F,
Sormani P et al (2017) Quantitative changes in late gadolinium enhancement at cardiac magnetic resonance in the early phase of acute myocarditis.
Int...