Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
Acad Radiol. 2021 Feb;28(2):e35-e43. doi: 10.1016/j.acra.2020.01.034. Epub 2020 Mar 18.
To investigate whether multiparametric cardiac magnetic resonance (CMR) could detect and monitor inflammatory myocardial alterations in fulminant myocarditis.
Nineteen patients (35 ± 14 years, 37% male) with clinical diagnosis of fulminant myocarditis underwent CMR examinations at 3.0T 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). Cardiac parameters, such as edema ratio, LGE mass, native T1, T2 and extracellular volume were measured.
The left ventricular mass index (67 ± 15 versus 55 ± 12 g/m, p < 0.05) and interventricular septum thickness (10.4 ± 1.5 versus 8.3 ± 1.8 mm, p < 0.001) in acute stage was significantly higher compared to controls, and normalized at the chronic stage. All quantitative inflammation metrics, including edema ratio, LGE mass, native T1, T2 and extracellular volume were significantly (all p < 0.001) decreased in the follow-up scan, but still higher compared to controls. Compared to the controls, all global strain indices including circumferential, longitudinal and radial strain values were significantly impaired in acute stage (all p < 0.001). Native T1 and T2 values led to excellent diagnostic accuracy for discriminating fulminant myocarditis from healed myocarditis, with AUC of 0.947 and 0.931.
Multiparametric CMR could detect and monitor inflammation myocardial injuries in patients with fulminant myocarditis. Native T1 and T2 values achieved excellent diagnostic performance in distinguishing acute from healed myocarditis.
研究多参数心脏磁共振（CMR）是否可用于检测和监测暴发性心肌炎的炎症性心肌改变。
19 例临床诊断为暴发性心肌炎的患者（35±14 岁，37%为男性）在 3.0T 磁共振仪上进行检查，分别于急性期和 3 个月随访期进行 CMR 检查。对照组由 19 名健康志愿者组成。CMR 方案包括电影、黑血 T2 加权成像、T1 映射、T2 映射和晚期钆增强（LGE）。测量心脏参数，如水肿比、LGE 质量、原生 T1、T2 和细胞外容积。
与对照组相比，急性期左心室质量指数（67±15 与 55±12 g/m，p<0.05）和室间隔厚度（10.4±1.5 与 8.3±1.8 mm，p<0.001）明显更高，且在慢性期恢复正常。所有定量炎症指标，包括水肿比、LGE 质量、原生 T1、T2 和细胞外容积在随访扫描时均显著（均 p<0.001）降低，但仍高于对照组。与对照组相比，所有全局应变指数（包括周向、纵向和径向应变值）在急性期均明显受损（均 p<0.001）。原生 T1 和 T2 值在区分暴发性心肌炎与愈合性心肌炎方面具有出色的诊断准确性，AUC 分别为 0.947 和 0.931。
多参数 CMR 可用于检测和监测暴发性心肌炎患者的炎症性心肌损伤。原生 T1 和 T2 值在区分急性和愈合性心肌炎方面具有出色的诊断性能。
