Department of Radiology, Oslo University Hospital, Ullevaal, Oslo, Norway.
Int J Cardiovasc Imaging. 2012 Feb;28(2):327-35. doi: 10.1007/s10554-011-9812-7. Epub 2011 Feb 24.
Our objective was to evaluate the ability of CMR to visualize myocardial injuries over the course of myocarditis. We studied 42 patients (39 males, 3 females; age 37 ± 14 years) with myocarditis during the acute phase and after 12 ± 9 months. CMR included function analyses, T2-weighted imaging (T2 ratio), T1-weighted imaging before and after i.v. gadolinium injection (global relative enhancement; gRE), and late gadolinium enhancement (LGE). In the acute phase, the T2 ratio was elevated in 57%, gRE in 31%, and LGE was present in 64% of the patients. In 32 patients (76%) were any two (or more) out of three sequences abnormal. At follow-up, there was an increase in ejection fraction (57.4 ± 11.9% vs. 61.4 ± 7.6; P < 0.05) while both T2 ratio (2.04 ± 0.32 vs. 1.70 ± 0.28; P < 0.001) and gRE (4.07 ± 1.63 vs. 3.11 ± 1.22; P < 0.05) significantly decreased. The LGE persisted in 10 patients. Dilated cardiomyopathy was present in 3 patients and 4 patients received a defibrillator or a pacemaker. A comprehensive CMR approach is a useful tool to visualize myocardial tissue injuries over the course of myocarditis. CMR may help to differentiate acute from healed myocarditis, and add information for the differential diagnoses.
我们的目的是评估心脏磁共振（CMR）在心肌炎病程中观察心肌损伤的能力。我们研究了 42 例急性心肌炎患者（男 39 例，女 3 例；年龄 37 ± 14 岁）和 12 ± 9 个月后的患者。CMR 包括功能分析、T2 加权成像（T2 比值）、静脉注射钆前后的 T1 加权成像（整体相对增强；gRE）和延迟钆增强（LGE）。在急性期，57%的患者 T2 比值升高，31%的患者 gRE 升高，64%的患者存在 LGE。32 例患者（76%）中有任何两种（或更多）序列异常。随访时，射血分数增加（57.4 ± 11.9%比 61.4 ± 7.6%；P < 0.05），同时 T2 比值（2.04 ± 0.32 比 1.70 ± 0.28；P < 0.001）和 gRE（4.07 ± 1.63 比 3.11 ± 1.22；P < 0.05）均显著降低。10 例患者仍存在 LGE。3 例患者存在扩张型心肌病，4 例患者植入了除颤器或起搏器。综合 CMR 方法是观察心肌炎病程中心肌组织损伤的有用工具。CMR 可帮助区分急性和愈合性心肌炎，并提供鉴别诊断的信息。
