Magnetic resonance imaging findings in acute myocarditis and correlation with immunohistological parametersReport as inadecuate

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European Radiology

, Volume 21, Issue 6, pp 1259–1266

First Online: 30 November 2010Received: 09 May 2010Accepted: 25 October 2010


ObjectiveTo evaluate the role of MRI in diagnosing acute myocarditis by correlation with immunohistological parameters.

MethodsA total of 131 patients 85 men, 46 women; mean age, 44.9 years with suspected acute myocarditis were examined by MRI. The relative water content of the left ventricular myocardium as well as relative and late enhancement was correlated with the immunohistological results in biopsy specimens.

ResultsMyocardial inflammation was confirmed by immunohistology in 82 of the 131 patients investigated and ruled out in 49 patients. The sensitivity, specificity and accuracy for diagnosing myocarditis in patients with immunohistologically proven disease were 48.8%, 73.8% and 57.3%, respectively, for relative enhancement, 58.3%, 57.1% and 57.9% for relative water content, and 30.6%, 88.1% and 49.6% for late enhancement. A combination of all three parameters had 39,3% sensitivity and 91,3% specificity and 62,7% accuracy. Relative enhancement and late enhancement significantly correlated with the presence of myocarditis but relative oedema did not.

ConclusionRelative and late enhancement significantly correlate with the presence of myocarditis, while there is no significant correlation for relative oedema. Myocarditis cannot be reliably diagnosed using any of the three MRI parameters alone but combinations of parameters will improve specificity.

KeywordsMyocarditis Relative enhencement Relative edema Late enhancement Immunhistology  Download fulltext PDF

Author: Rainer Röttgen - Robert Christiani - Patrick Freyhardt - Matthias Gutberlet - Hans Peter Schultheiss - Bernd Hamm - Uwe K


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