Which late gadolinium enhancement pattern is seen in the images?
There is a focal subepicardial pattern.
Heart rate: 65 bpm, haematocrit: 0.42
Image quality: mild respiratory artifacts, otherwise no limitations
Morphology and functional analysis (endo-volume):
LV-EDVI: 90 mL/m²
LV-ESVI: 43 mL/m²
LV-SVI: 46 mL/m²
LV-EF: 52%
cardiac output: 5.7 L/min
cardiac index: 3.0 L/min/m²
LV-ED wall + papillary mass: 77 g
septum thickness: 8 mm
Findings:
No regional left ventricular wall motion abnormalities.
Visually normal atrial size.
No significant cardiac valve pathology.
No intracavitary thrombi.
Small bilateral pleural effusions.
Minimal pericardial enhancement without thickening, adjacent to the left ventricular free wall.
No pericardial effusion.
Myocardial tissue properties (according to Lake Louise criteria II) 1:
Regional myocardial oedema is visible in the lateral wall from anterolateral to inferior and basal to apical.
Patchy subepicardial late gadolinium enhancement (LGE) visible in the lateral and inferior segments from basal to apical.
T1 mapping: >1100 ms* (z-score: ~3-4)
extracellular volume (ECV): 34-40% in lateral and inferior segments
T2 mapping: 65-70 ms* (z-score: ~5-7)
*Normal reference ranges based on local data:
-
native T1: 940-1060 ms; ECV: <32%; T2: 44-56 ms
Impression:
Cardiac MRI findings are consistent with acute inflammatory changes of the whole lateral wall of the myocardium or acute myocarditis.