Kurzfassung

Purpose:
To assess the value of cardiac MRI in patients with acute chest pain, elevated cardiac enzymes and a negative coronary angiogram and analyze factors of influence on the accuracy of the diagnosis

Methods and Materials:
In a 39 months period, 126 patients from the chest pain unit could be included in this study.The MR imaging protocol was kept as simple as possible and consisted of cine, edema sensitive and late Gadolinium enhancement imaging. Clinical follow up and the synopsis of all...Purpose:
To assess the value of cardiac MRI in patients with acute chest pain, elevated cardiac enzymes and a negative coronary angiogram and analyze factors of influence on the accuracy of the diagnosis

Methods and Materials:
In a 39 months period, 126 patients from the chest pain unit could be included in this study.The MR imaging protocol was kept as simple as possible and consisted of cine, edema sensitive and late Gadolinium enhancement imaging. Clinical follow up and the synopsis of all clinical, laboratory and imaging data were the basis for establishing a consensus based diagnosis. This diagnosis served as the standard of reference.

Results:
Besides the five main diagnoses (ischemic cardiomyopathy, dilative cardiomyopathy, myocarditis, TakoTsubo cardiomyopathy and hypertensive cardiomyopathy; n =111) there were miscellaneous cardiac diagnoses (e.g. hypertrophic cardiomyopathy, cardiac amyloidosis or non-compaction cardiomyopathy n = 15).
Compared with the final standard of reference diagnosis, cMRI enabled establishing the final diagnosis in 110/126 patients (87 %). Only in 16 patients cMRI could not detect the final diagnosis. Further analysis showed no significant correlation between age, sex and time to cMRI examination and the correctness of the diagnosis (p >0.05). The only important factor was the kind of diagnosis itself.

Conclusion:
cMRI helps establishing the final diagnosis in patients with acute chest pain, elevated cardiac enzymes and a negative coronary angiogram in the vast majority of cases. Age, sex and time to examination had no influence on the accuracy of the diagnosis.» weiterlesen» einklappen