What cut off values were published regarding global oedema and early gadolinium enhancement (EGE) if myocardial Inflammation is suspected?
Signal intensity and enhancement ratios between myocardium and skeletal muscle should be ≥ 2 (for myocardial oedema) and ≥ 4 for early gadolinium enhancement (EGE).
Which findings point towards the cardiac sarcoidosis?
The focal, patchy intramural/subepicardial late gadolinium enhancement and the massive pericardial effusion together with the clinical background. The borderline relative water content and the early gadolinium enhancement (EGE) points towards active inflammatory changes.
Heart rate: 67 bpm, BSA: 1,88 m²
Image quality: no limitations
Morphology and functional analysis:
- LV EDVI: 93 ml/m²
- LV- ESVI: 43 ml/m²
- LV SVI: 50 ml/m²
- LV EF: 53 %
- Cardiac output: 6.7 l/min
- Cardiac index: 3,6 l/min/m²
- LV-ED mass + papillary muscle: 52 g/m²
- Septum thickness: 8 mm
Mild global hypokinesia. No regional left ventricular wall motion abnormalities.
Visually normal atrial size.
Mild calcification of the anterior mitral leaflet. Mild mitral insufficiency.
No intercavitary thrombi.
Myocardial tissue properties:
No regional myocardial oedema. Mildly increased relative water content on STIR images.
The early gadolinium enhancement (EGE) ratio was significantly increased.
Patchy intramyocardial and subepicardial enhancement is visible in the apical/midventricular inferior segments, best visible on the 2-chamber view (2ch).
Extensive, circular pericardial effusion.
Cardiac MRI findings are consistent with non-ischaemic myocardial inflammation.
Massive circular pericardial effusion. Mild systolic dysfunction.
In view of the clinical information and the previous thoracic CT, the findings are consistent with cardiac sarcoidosis.