Radiologie Centrale - Pôle Cardiovasculaire et Thoracique, CHU de Montpellier, Montpellier, France.
Eur Radiol. 2010 Jan;20(1):65-72. doi: 10.1007/s00330-009-1519-y. Epub 2009 Aug 6.
The purpose of the study was to prospectively assess the clinical impact of routinely performed delayed enhancement imaging in suspected acute myocarditis. A two-centre prospective study was performed in patients with suspected acute myocarditis. The protocol included horizontal long axis, vertical long axis and short axis ciné MR and delayed enhancement imaging after Gd-DTPA infusion (0.2 mmol/kg). Sixty consecutive patients were enrolled (aged 49.4 +/- 17.8 years). MRI demonstrated delayed enhancement sparing the subendocardicardial layer in 51.6% of patients, concordant with the diagnosis of acute myocarditis; 16.7% of patients exhibited delayed enhancement involving the subendocardial layer with irregular margins, concordant with the diagnosis of acute myocardial infarction; 31.7% of patients had delayed enhancement imaging that was considered normal. Routine imaging to identify delayed enhancement provided crucial information in suspected acute myocarditis by reinforcing the diagnosis in 51.6% of patients and correcting a misdiagnosed acute myocardial infarction in 16.7% of patients.
这项研究的目的是前瞻性评估常规延迟增强成像在疑似急性心肌炎中的临床影响。这项研究在疑似急性心肌炎患者中进行了一项两中心前瞻性研究。方案包括水平长轴、垂直长轴和短轴电影 MR 以及钆二乙三胺五醋酸（Gd-DTPA）输注（0.2mmol/kg）后的延迟增强成像。连续纳入 60 例患者（年龄 49.4 ± 17.8 岁）。MRI 显示 51.6%的患者延迟增强保留心外膜下层，与急性心肌炎的诊断一致；16.7%的患者表现为延迟增强累及心内膜下层，边缘不规则，与急性心肌梗死的诊断一致；31.7%的患者延迟增强成像被认为是正常的。常规成像以识别延迟增强通过在 51.6%的患者中强化诊断，并在 16.7%的患者中纠正误诊的急性心肌梗死，为疑似急性心肌炎提供了关键信息。
