PURPOSE: To prospectively determine whether early first-pass perfusion and delayed-enhancement magnetic resonance (MR) imaging sequences can enable differentiation of acute myocardial infarction (AMI) from myocarditis in patients with acute chest pain. MATERIALS AND METHODS: All examinations were performed according to guidelines of the institutional board on medical ethics and clinical investigation and after informed patient consent was obtained. Fifty-five patients with a clinical presentation suggestive but not typical of AMI were examined. At final diagnosis, 31 patients had AMI and 24 had myocarditis. At-rest MR imaging was performed and included first-pass perfusion and delayed-enhancement sequences. Three independent observers read each image data set separately and then in consensus. The main abnormalities included first-pass perfusion defects and delayed highly enhancing areas. The numbers and distributions of involved segments and the transmural extents and the shapes of the highly enhancing areas were noted. For comparisons between the AMI and myocarditis patient groups, the chi2 test was used to assess the locations of the abnormalities and the Mann-Whitney U test was used to assess the numbers of involved segments. The final diagnoses were obtained with coronary angiography as the reference standard for the AMI group and on the basis of normal coronary angiographic findings and the spontaneous resolution of clinical symptoms and wall motion abnormalities for the myocarditis group. RESULTS: MR imaging patterns were significantly different between the two cardiac disease groups (P < .05). All the patients with AMI had a segmental early subendocardial defect, with corresponding segmental subendocardial or transmural delayed high enhancement in a predominantly anteroseptal or inferior vascular distribution in 28 patients. All patients with AMI had stenosis of at least the infarct-affected coronary artery. All but one of the patients with myocarditis had no early defect and focal or diffuse nonsegmental nonsubendocardial delayed enhancement predominantly in an inferolateral location. CONCLUSION: Use of combined early- and late-perfusion MR imaging sequences helps to distinguish AMI from myocarditis. RSNA, 2005
PURPOSE: To prospectively determine whether early first-pass perfusion and delayed-enhancement magnetic resonance (MR) imaging sequences can enable differentiation of acute myocardial infarction (AMI) from myocarditis in patients with acute chest pain. MATERIALS AND METHODS: All examinations were performed according to guidelines of the institutional board on medical ethics and clinical investigation and after informed patient consent was obtained. Fifty-five patients with a clinical presentation suggestive but not typical of AMI were examined. At final diagnosis, 31 patients had AMI and 24 had myocarditis. At-rest MR imaging was performed and included first-pass perfusion and delayed-enhancement sequences. Three independent observers read each image data set separately and then in consensus. The main abnormalities included first-pass perfusion defects and delayed highly enhancing areas. The numbers and distributions of involved segments and the transmural extents and the shapes of the highly enhancing areas were noted. For comparisons between the AMI and myocarditispatient groups, the chi2 test was used to assess the locations of the abnormalities and the Mann-Whitney U test was used to assess the numbers of involved segments. The final diagnoses were obtained with coronary angiography as the reference standard for the AMI group and on the basis of normal coronary angiographic findings and the spontaneous resolution of clinical symptoms and wall motion abnormalities for the myocarditis group. RESULTS: MR imaging patterns were significantly different between the two cardiac disease groups (P < .05). All the patients with AMI had a segmental early subendocardial defect, with corresponding segmental subendocardial or transmural delayed high enhancement in a predominantly anteroseptal or inferior vascular distribution in 28 patients. All patients with AMI had stenosis of at least the infarct-affected coronary artery. All but one of the patients with myocarditis had no early defect and focal or diffuse nonsegmental nonsubendocardial delayed enhancement predominantly in an inferolateral location. CONCLUSION: Use of combined early- and late-perfusion MR imaging sequences helps to distinguish AMI from myocarditis. RSNA, 2005
Authors: Yvan Mivelaz; Nicole Sekarski; Salah Dine Qanadli; Erik Jan Meijboom; Stefano Di Bernardo Journal: Eur J Pediatr Date: 2006-11-07 Impact factor: 3.183
Authors: Annamalai Senthilkumar; Maulik D Majmudar; Chetan Shenoy; Han W Kim; Raymond J Kim Journal: Heart Fail Clin Date: 2009-07 Impact factor: 3.179
Authors: Kimberly I Mills; Julie A Vincent; Warren A Zuckerman; Timothy M Hoffman; Charles E Canter; Audrey C Marshall; Elizabeth D Blume; Lisa Bergersen; Kevin P Daly Journal: Pediatr Cardiol Date: 2016-06-06 Impact factor: 1.655