Dupuis J M, Victor J, Furber A, Pézard P, Lejeune L L, Tadei A
Service de cardiologie, CHU d'Angers.
Arch Mal Coeur Vaiss. 1994 Jan;87(1):105-10.
The authors report the value of magnetic resonance imaging (MRI) in a case of cardiac sarcoidosis presenting with syncopal ventricular tachycardia (VT). The images were acquired in a monomorphic multiplane echo spin sequence. A 25 millisecond interval was chosen for the weighted T1 sequence. A second weighted T2 sequence using an interval of 70 milliseconds was then performed. The acquisitions were recorded in these planes axial, sagittal and coronal. The thickness of the sections was 8 mm. MRI was useful in locating the exact site and extent of the lesions; this enabled the operators to perform "guided" endomyocardial biopsies. In the weighted T1 sequences, these biopsies showed zones of increased intramyocardial signal density, more pronounced on the second weighted T2 sequences. Moreover, it was possible to follow up the outcome of these lesions with steroid therapy and observe their partial regression. These non-specific appearances may be observed in all inflammatory conditions but, in the context of systemic sarcoidosis, are very suggestive of cardiac involvement. In view of the clinical latency of cardiac sarcoidosis and its poor prognosis, the non-invasive character of MRI should make this a routine investigation in all patients with systemic sarcoidosis.
