Kurzfassung

Purpose: to assess the value of CMRI in an outpatient cohort.
Materials and Methods: During an eighteen months period, 235 patients with 255 CMRI examinations could be included in the study. 97 patients were referred for primary diagnosis of coronary artery disease (CAD), 64 presented with known CAD, 52 with suspected myocarditis or cardiomyopathy, and 19 for further quantification of shunt or valvular vitia. The examination protocol was determined by the clinical suspicion, and included Cine...Purpose: to assess the value of CMRI in an outpatient cohort.
Materials and Methods: During an eighteen months period, 235 patients with 255 CMRI examinations could be included in the study. 97 patients were referred for primary diagnosis of coronary artery disease (CAD), 64 presented with known CAD, 52 with suspected myocarditis or cardiomyopathy, and 19 for further quantification of shunt or valvular vitia. The examination protocol was determined by the clinical suspicion, and included Cine imaging, delayed enhancement imaging, perfusion imaging at rest and under adenosine stress, as well as STIR imaging and phase contrast measurements. Patients could be followed-up at least one year after CMRI.
Results: In patients with known or suspected CAD (n = 161), myocardial ischemia under stress was ruled out in 126/161 (78.2 %) patients. There were no major cardiac events in these patients during the 1-year-follow-up. 28/35 patients with myocardial ischemia under adenosine stress underwent coronary angiogaphy (CA), where a significant stenosis could be confirmed in 26. 7 patients refused CA. Myocarditis and cardiomyopathies could be confirmed in 35/52 (66 %) and ruled out in 17/52 (34 %) patients. Follow-up studies documented the normalization of findings in 17 patients with acute myocarditis. CMRI enabled quantification in patients with valvular and/or shunt vitia.
Conclusion: CMRI proved to be a valuable tool in this study on outpatients. It reliably detected patients with relevant coronary artery stenosis and avoided CA in patients without stress-induced ischemia. CMRI enabled differention of cardiomyopathies and myocarditis and quantification of cardiac vitia and thus decisively guided further therapy.
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