Kurzfassung

Purpose: to assess the value of CMRI in patients with clinical suspicion of acute myocarditis.
Materials and Methods: 49 patients with suspected acute myocarditis and 11 control patients could be included. Cardiac catheterization was available in 21/49 patients. The study protocol included fat-suppressed STIR imaging for assessment of myocardial edema, Cine imaging for assessment of global and regional myocardial function, and delayed contrast-enhanced MRI for assessment of myocardial tissue...Purpose: to assess the value of CMRI in patients with clinical suspicion of acute myocarditis.
Materials and Methods: 49 patients with suspected acute myocarditis and 11 control patients could be included. Cardiac catheterization was available in 21/49 patients. The study protocol included fat-suppressed STIR imaging for assessment of myocardial edema, Cine imaging for assessment of global and regional myocardial function, and delayed contrast-enhanced MRI for assessment of myocardial tissue damage. Follow-up studies were done at 6 and 12 months in 20 and 11 patients, respectively.
Results: In the patient group, myocardial edema was present in all patients, in 47 cases it involved the left ventricular (LV) myocardium, in 28 patients the right ventricular (RV) myocardium. LV ejection fraction was normal in 22, slightly reduced in 16, moderate reduced in 6 and severely reduced in 5 patients. Regional wall motion abnormalities of LV segments were seen in 30, and of RV segments in 9 patients. Areas of late enhancement were detected in 30 patients in the left ventricle, and in 7 patients in the right ventricle. Follow-up studies documented an improvement of LV function and regional wall motion abormalities, as well as myocardial edema. However, these improvements became apparent mostly after 12 months. Areas of late enhancement showed a tendency to decrease. The control group did not show any of the findings of the patient group.
Conclusion: Myocardial edema, regional wall motion abnormalities and areas of subepicardial late enhancement are characteristic findings in acute myocarditis and can be detected up to one year after the onset of symptoms.
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