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• Clinical Article •
Study of quantitative multiparametric CMR in the detection and monitoring of myocardial edema in fulminant myocarditis
LI Haojie  ZHU Hui  XIA Liming 

Cite this article as: Li HJ, Zhu H, Xia LM. Study of quantitative multiparametric CMR in the detection and monitoring of myocardial edema in fulminant myocarditis. Chin J Magn Reson Imaging, 2019, 10(12): 899-903. DOI:10.12015/issn.1674-8034.2019.12.005.


[Abstract] Objective: To assess quantitative multiparametric cardiac magnetic resonance (CMR) to detect and monitor inflammation myocardial injuries in fulminant myocarditis.Materials and Methods: 19 patients with clinical diagnosis of fulminant myocarditis underwent CMR examination at 3.0 T in the acute phase and at 3-months follow up. The control group consisted of 19 healthy volunteers. The CMR protocol included cine, black blood T2-weighted imaging, T1 mapping, T2 mapping and late gadolinium enhancement (LGE). Myocardial strain analysis was performed on routine cine images.Results: Compared with patients with acute fulminant myocarditis, native T1[1414(1357, 1459) vs 1267(1249,1298), P<0.001], T2[47(43, 49) vs 39 (38, 43), P<0.001] and ECV [0.36(0.32, 0.40) vs 0.29(0.26, 0.30), P<0.001] were markedly reduced in the follow-up scan, but still elevated compared to healthy controls. Compared with the controls, strain indices were all significantly impaired in acute stage. Native T1 and T2 values led to excellent diagnostic accuracy for discriminating acute myocarditis from healed myocarditis, with AUC of 0.947 and 0.931 .Conclusions: Quantitative multiarametric CMR can accurately detect and monitor inflammatory myocardial injuries in patients with fulminant myocarditis. Native T1 and T2 values achieved excellent diagnostic performance in distinguishing acute from healed myocarditis.
[Keywords] magnetic resonance imaging；myocarditis；strain；cardiac magnetic resonance

LI Haojie Department of Radiology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China

ZHU Hui Department of Radiology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China

XIA Liming * Department of Radiology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China

*Correspondence to: Xia LM, E-mail: lmxia@tjh.tjmu.edu.cn

Conflicts of interest   None.

ACKNOWLEDGMENTS  This work was part of National Natural Science Foundation of China No. 81873889
Received  2019-09-16
DOI: 10.12015/issn.1674-8034.2019.12.005
Cite this article as: Li HJ, Zhu H, Xia LM. Study of quantitative multiparametric CMR in the detection and monitoring of myocardial edema in fulminant myocarditis. Chin J Magn Reson Imaging, 2019, 10(12): 899-903. DOI:10.12015/issn.1674-8034.2019.12.005.

[1]
Pollack A, Kontorovich AR, Fuster V, et al. Viral myocarditis--diagnosis, treatment options, and current controversies. Nat Rev Cardiol, 2015, 12(11): 670-680.
[2]
Caforio AL, Pankuweit S, Arbustini E, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J, 2013, 34(33): 2636-2648.
[3]
Ginsberg F, Parrillo JE. Fulminant myocarditis. Crit Care Clin, 2013, 29(3): 465-483.
[4]
Maisch B, Ruppert V, Pankuweit S. Management of fulminant myocarditis: a diagnosis in search of its etiology but with therapeutic options. Curr Heart Fail Rep, 2014, 11(2): 166-177.
[5]
Asaumi Y, Yasuda S, Morii I, et al. Favourable clinical outcome in patients with cardiogenic shock due to fulminant myocarditis supported by percutaneous extracorporeal membrane oxygenation. Eur Heart J, 2005, 26(20): 2185-2192.
[6]
Hauck AJ, Kearney DL, Edwards WD. Evaluation of postmortem endomyocardial biopsy specimens from 38 patients with lymphocytic myocarditis: implications for role of sampling error. Mayo Clin Proc, 1989, 64(10): 1235-1245.
[7]
Luetkens JA, Doerner J, Thomas DK, et al. Acute myocarditis: multiparametric cardiac MR imaging. Radiology, 2014, 273(2): 383-392.
[8]
Bonner F, Spieker M, Haberkorn S, et al. Myocardial T2 mapping increases noninvasive diagnostic accuracy for biopsy-proven myocarditis. JACC Cardiovasc Imaging, 2016, 9(12): 1467-1469.
[9]
Andre F, Stock FT, Riffel J, et al. Incremental value of cardiac deformation analysis in acute myocarditis: a cardiovascular magnetic resonance imaging study. Int J Cardiovasc Imaging, 2016, 32(7): 1093-1101.
[10]
Luetkens JA, Schlesinger-Irsch U, Kuetting DL, et al. Feature-tracking myocardial strain analysis in acute myocarditis: diagnostic value and association with myocardial oedema. Eur Radiol, 2017, 27(11): 4661-4671.
[11]
Bohnen S, Radunski UK, Lund GK, et al. Tissue characterization by T1 and T2 mapping cardiovascular magnetic resonance imaging to monitor myocardial inflammation in healing myocarditis. Eur Heart J Cardiovasc Imaging, 2017, 18(7): 744-751.
[12]
von Knobelsdorff-Brenkenhoff F, Schuler J, Doganguzel S, et al. Detection and monitoring of acute myocarditis applying quantitative cardiovascular magnetic resonance. Circ Cardiovasc Imaging, 2017, 10(2): 623-625.
[13]
Luetkens JA, Homsi R, Dabir D, et al. Comprehensive cardiac magnetic resonance for short-term follow-up in acute myocarditis. J Am Heart Assoc, 2016, 5(7): e3603.
[14]
Spieker M, Haberkorn S, Gastl M, et al. Abnormal T2 mapping cardiovascular magnetic resonance correlates with adverse clinical outcome in patients with suspected acute myocarditis. J Cardiovasc Magn Reson, 2017, 19(1): 38.
[15]
Radunski UK, Lund GK, Stehning C, et al. CMR in patients with severe myocarditis: diagnostic value of quantitative tissue markers including extracellular volume imaging. JACC Cardiovasc Imaging, 2014, 7(7): 667-675.

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