Zidi Asma, Zairi Ihsen, Mzoughi Khadija, Zakhama Lilia, Kamoun Ikram, Ben Halima Afef, Ridene Imen
Tunis Med. 2016 Nov;94(11):639.
Cardiovascular magnetic resonance (CMR) has become the examination of choice in case of suspicion of acute myocarditis. Late gadolinium enhancement (LGE) imaging is very important to establish this diagnosis. Cine MRI sequences are useful for the study of the myocardial contractility.
The purpose is to estimate the value of cine MRI sequences before and after injection for the diagnosis of acute myocarditis compared with late gadolinium enhanced sequences.
We prospectively included 40 patients having a high suspicion of acute myocarditis and examined using a 1.5 Tesla CMR. Cine MRI sequences before and after injection were performed. The protocol also include T2-weighted short- tau-inversion-recovery (STIR T2) fast spin echo MRI and LGE imaging eight minutes after injection with visual adjustment of inversion time.
Delayed enhancement was found among 23 patients. Fifteen patients (65 %) presented a spontaneous hyper signal detected visually on Cine MRI sequences before injection and 11 patients (48 %) on STIR T2. The hyper signal on Cine MRI sequences after injection of gadolinium was the same topography that the late raising at 23 patients. In addition, we highlighted a significant difference between this hyper signal before injection and the left ventricle ejection fraction (p=0.022) as well as with the telesystolic volume of the left ventricle (LV) indexed by the body mass (p=0.039).
Our study suggests that Cine MRI sequences after injection are of equal performance in the diagnosis of acute myocarditis as the LGE sequences and its contibution is important when we want to shorten the examination or when inversion time isn't optimal.
心脏磁共振成像（CMR）已成为疑似急性心肌炎时的首选检查方法。延迟钆增强（LGE）成像对于确诊该病非常重要。电影MRI序列有助于研究心肌收缩力。
目的是评估注射前后的电影MRI序列在诊断急性心肌炎方面的价值，并与延迟钆增强序列进行比较。
我们前瞻性纳入了40例高度疑似急性心肌炎的患者，并使用1.5特斯拉CMR进行检查。进行了注射前后的电影MRI序列检查。该方案还包括T2加权短反转恢复（STIR T2）快速自旋回波MRI以及注射后八分钟的LGE成像，并对反转时间进行视觉调整。
23例患者发现延迟强化。15例患者（65%）在注射前的电影MRI序列上可见自发高信号，11例患者（48%）在STIR T2序列上可见。注射钆后电影MRI序列上的高信号与23例患者延迟强化的部位相同。此外，我们强调了注射前的这种高信号与左心室射血分数（p=0.022）以及以体重指数化的左心室舒张末期容积（LV）之间存在显著差异（p=0.039）。
我们的研究表明，注射后的电影MRI序列在诊断急性心肌炎方面与LGE序列具有同等性能，并且当我们想要缩短检查时间或反转时间不理想时，其作用很重要。
