MRI - cardiac MRI
Axial SSFP
2ch cine SSFP
cine SSFP
short axis cine SSFP
3ch cine SSFP
4ch STIR
short axis STIR
short axis native T1 mapping
2ch IR-GE (LGE)
4ch IR-GE (LGE)
PSIR
short axis IR-GE (LGE)
3ch IR-GE (LGE)
short axis postcontrast T1 mapping
What is seen in the late gadolinium enhancement images?
Moderate pericardial effusion (10-20 mm) and pericardial enhancement with pericardial thickening (≥3 mm).
What is a differential diagnosis in a patient with pericardial effusion and elevated troponins?
Perimyocarditis.
What criteria need to be fulfilled in nonischemic myocardial inflammation?
According to the updated version of the Lake Louise criteria (2018), a cardiac MRI scan provides strong evidence for myocardial inflammation if at least one T2-based criterion for myocardial oedema and one T1-based criterion for associated non-ischaemic myocardial injury is positive. There are also two supportive criteria, being pericarditis and systolic left-ventricular dysfunction.
Findings:
Heart rate: 49 bpm, BSA: 2,01 m²
Image quality: some respiratory movement during the T1 mapping
Morphology and functional analysis:
- LV-EDVI: 74 mL/m²
- LV-ESVI: 29 mL/m²
- LV-SVI: 45 mL/m²
- LV-EF: 60%
- Cardiac output: 4.4 L/min
- Cardiac index: 2.2 L/min/m²
- LV-ED mass + papillary muscle: 67 g/m²
- Septum thickness: 10 mm
No regional left ventricular wall motion abnormalities.
Visually normal atrial size.
No intercavitary thrombi.
Myocardial tissue properties:
No regional or global myocardial oedema.
No subendocardial, intramyocardial or subepicardial late gadolinium enhancement is visible.
T1 mapping native: 1005±28 ms [948-1060 ms*], extracellular volume (ECV): ≈ 26.3%
*native T1 reference range based on local data
Moderate circular pericardial effusion.
Pericardial enhancement. Pericardial thickening (3-4 mm).
Small bilateral pleural effusions.
Impression:
Moderate pericardial effusion and pericardial enhancement indicating pericarditis.
No signs of acute myocardial inflammation.
Viable myocardium, no subendocardial scar seen.