Cardiovascular Magnetic Resonance in Myocarditis: A JACC White Paper

Overview

Journal J Am Coll Cardiol

Specialty Cardiology & Vascular Diseases

Date 2009 Apr 25

PMID 19389557

Citations 852

Authors

Matthias G Friedrich

Udo Sechtem

Jeanette Schulz-Menger

Godtfred Holmvang

Pauline Alakija

Leslie T Cooper

James A White

Hassan Abdel-Aty

Matthias Gutberlet

Sanjay Prasad

Anthony Aletras

Jean-Pierre Laissy

Ian Paterson

Neil G Filipchuk

Andreas Kumar

Matthias Pauschinger

Peter Liu

Affiliations

Soon will be listed here.

Abstract

Cardiovascular magnetic resonance (CMR) has become the primary tool for noninvasive assessment of myocardial inflammation in patients with suspected myocarditis. The International Consensus Group on CMR Diagnosis of Myocarditis was founded in 2006 to achieve consensus among CMR experts and develop recommendations on the current state-of-the-art use of CMR for myocarditis. The recommendations include indications for CMR in patients with suspected myocarditis, CMR protocol standards, terminology for reporting CMR findings, and diagnostic CMR criteria for myocarditis (i.e., "Lake Louise Criteria").

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References

Gagliardi M, Bevilacqua M, Di Renzi P, Picardo S, Passariello R, Marcelletti C . Usefulness of magnetic resonance imaging for diagnosis of acute myocarditis in infants and children, and comparison with endomyocardial biopsy. Am J Cardiol. 1991; 68(10):1089-91. DOI: 10.1016/0002-9149(91)90501-b. View

Kim R, Shah D, Judd R . How we perform delayed enhancement imaging. J Cardiovasc Magn Reson. 2003; 5(3):505-14. DOI: 10.1081/jcmr-120022267. View

Kim R, Fieno D, Parrish T, Harris K, Chen E, Simonetti O . Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. Circulation. 1999; 100(19):1992-2002. DOI: 10.1161/01.cir.100.19.1992. View

Friedrich M, Schulz-Menger J, Strohm O, Dick A, Dietz R . The diagnostic impact of 2D- versus 3D- left ventricular volumetry by MRI in patients with suspected heart failure. MAGMA. 2001; 11(1-2):16-9. DOI: 10.1007/BF02678483. View

Rehwald W, Fieno D, Chen E, Kim R, Judd R . Myocardial magnetic resonance imaging contrast agent concentrations after reversible and irreversible ischemic injury. Circulation. 2002; 105(2):224-9. DOI: 10.1161/hc0202.102016. View

Aletras A, Kellman P, Derbyshire J, Arai A . ACUT2E TSE-SSFP: a hybrid method for T2-weighted imaging of edema in the heart. Magn Reson Med. 2008; 59(2):229-35. DOI: 10.1002/mrm.21490. View

Bloomer T, Plein S, Radjenovic A, Higgins D, Jones T, Ridgway J . Cine MRI using steady state free precession in the radial long axis orientation is a fast accurate method for obtaining volumetric data of the left ventricle. J Magn Reson Imaging. 2001; 14(6):685-92. DOI: 10.1002/jmri.10019. View

Baughman K . Diagnosis of myocarditis: death of Dallas criteria. Circulation. 2006; 113(4):593-5. DOI: 10.1161/CIRCULATIONAHA.105.589663. View

Aretz H, Billingham M, Edwards W, Factor S, Fallon J, Fenoglio Jr J . Myocarditis. A histopathologic definition and classification. Am J Cardiovasc Pathol. 1987; 1(1):3-14. View

10.

Hiramitsu S, Morimoto S, Kato S, Uemura A, Kubo N, Kimura K . Transient ventricular wall thickening in acute myocarditis: a serial echocardiographic and histopathologic study. Jpn Circ J. 2001; 65(10):863-6. DOI: 10.1253/jcj.65.863. View

11.

Yelgec N, Dymarkowski S, Ganame J, Bogaert J . Value of MRI in patients with a clinical suspicion of acute myocarditis. Eur Radiol. 2007; 17(9):2211-7. DOI: 10.1007/s00330-007-0612-3. View

12.

Karjalainen J, Heikkila J . "Acute pericarditis": myocardial enzyme release as evidence for myocarditis. Am Heart J. 1986; 111(3):546-52. DOI: 10.1016/0002-8703(86)90062-1. View

13.

Liu P, Mason J . Advances in the understanding of myocarditis. Circulation. 2001; 104(9):1076-82. DOI: 10.1161/hc3401.095198. View

14.

Schulz-Menger J, Wassmuth R, Abdel-Aty H, SIEGEL I, Franke A, Dietz R . Patterns of myocardial inflammation and scarring in sarcoidosis as assessed by cardiovascular magnetic resonance. Heart. 2006; 92(3):399-400. PMC: 1860837. DOI: 10.1136/hrt.2004.058016. View

15.

Richardson P, McKenna W, Bristow M, Maisch B, MAUTNER B, OConnell J . Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation. 1996; 93(5):841-2. DOI: 10.1161/01.cir.93.5.841. View

16.

Zagrosek A, Wassmuth R, Abdel-Aty H, Rudolph A, Dietz R, Schulz-Menger J . Relation between myocardial edema and myocardial mass during the acute and convalescent phase of myocarditis--a CMR study. J Cardiovasc Magn Reson. 2008; 10:19. PMC: 2396625. DOI: 10.1186/1532-429X-10-19. View

17.

Felker G, Boehmer J, Hruban R, Hutchins G, Kasper E, Baughman K . Echocardiographic findings in fulminant and acute myocarditis. J Am Coll Cardiol. 2000; 36(1):227-32. DOI: 10.1016/s0735-1097(00)00690-2. View

18.

Ingkanisorn W, Paterson D, Calvo K, Rosing D, Schwartzentruber D, Fuisz A . Cardiac magnetic resonance appearance of myocarditis caused by high dose IL-2: similarities to community-acquired myocarditis. J Cardiovasc Magn Reson. 2006; 8(2):353-60. DOI: 10.1080/10976640500452000. View

19.

Shanes J, Ghali J, Billingham M, Ferrans V, Fenoglio J, Edwards W . Interobserver variability in the pathologic interpretation of endomyocardial biopsy results. Circulation. 1987; 75(2):401-5. DOI: 10.1161/01.cir.75.2.401. View

20.

Abdel-Aty H, Boye P, Zagrosek A, Wassmuth R, Kumar A, Messroghli D . Diagnostic performance of cardiovascular magnetic resonance in patients with suspected acute myocarditis: comparison of different approaches. J Am Coll Cardiol. 2005; 45(11):1815-22. DOI: 10.1016/j.jacc.2004.11.069. View