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Myocarditis
Suhny Abbara, MD, FACR, FSCCT; Prabhakar Rajiah, MBBS, MD, FRCR, FSCMR; Cameron Hassani, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Inflammatory involvement of myocardium with necrosis &/or degeneration of adjacent myocytes

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Echocardiographic Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              • Reporting Tips

                                                Selected References

                                                1. Ferreira VM et al: Cardiovascular magnetic resonance in nonischemic myocardial inflammation: expert recommendations. J Am Coll Cardiol. 72(24):3158-76, 2018
                                                2. Messroghli DR et al: Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: a consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI). J Cardiovasc Magn Reson. 19(1):75, 2017
                                                3. Greulich S et al: Myocardial inflammation-are we there yet? Curr Cardiovasc Imaging Rep. 8(3):6, 2015
                                                4. Ferreira VM et al: Native T1-mapping detects the location, extent and patterns of acute myocarditis without the need for gadolinium contrast agents. J Cardiovasc Magn Reson. 16:36, 2014
                                                5. Luetkens JA et al: Acute myocarditis: multiparametric cardiac MR imaging. Radiology. 273(2):383-92, 2014
                                                6. Grün S et al: Long-term follow-up of biopsy-proven viral myocarditis: predictors of mortality and incomplete recovery. J Am Coll Cardiol. 59(18):1604-15, 2012
                                                7. Friedrich MG et al: Cardiovascular magnetic resonance in myocarditis: a JACC White Paper. J Am Coll Cardiol. 53(17):1475-87, 2009
                                                8. Dambrin G et al: Diagnostic value of ECG-gated multidetector computed tomography in the early phase of suspected acute myocarditis. A preliminary comparative study with cardiac MRI. Eur Radiol. 17(2):331-8, 2007
                                                9. Mahrholdt H et al: Presentation, patterns of myocardial damage, and clinical course of viral myocarditis. Circulation. 114(15):1581-90, 2006
                                                10. Abdel-Aty H et al: Diagnostic performance of cardiovascular magnetic resonance in patients with suspected acute myocarditis: comparison of different approaches. J Am Coll Cardiol. 45(11):1815-22, 2005
                                                11. Liu PP et al: Cardiovascular magnetic resonance for the diagnosis of acute myocarditis: prospects for detecting myocardial inflammation. J Am Coll Cardiol. 45(11):1823-5, 2005
                                                12. Roditi GH et al: MRI changes in myocarditis--evaluation with spin echo, cine MR angiography and contrast enhanced spin echo imaging. Clin Radiol. 55(10):752-8, 2000
                                                13. Friedrich MG et al: Contrast media-enhanced magnetic resonance imaging visualizes myocardial changes in the course of viral myocarditis. Circulation. 97(18):1802-9, 1998
                                                14. Alpert JS et al: Update in cardiology. Ann Intern Med. 125(1):40-6, 1996
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Definitions

                                                            • Inflammatory involvement of myocardium with necrosis &/or degeneration of adjacent myocytes

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Echocardiographic Findings

                                                                    • Nuclear Medicine Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Staging, Grading, & Classification

                                                                              • Microscopic Features

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Consider

                                                                                          • Image Interpretation Pearls

                                                                                            • Reporting Tips

                                                                                              Selected References

                                                                                              1. Ferreira VM et al: Cardiovascular magnetic resonance in nonischemic myocardial inflammation: expert recommendations. J Am Coll Cardiol. 72(24):3158-76, 2018
                                                                                              2. Messroghli DR et al: Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: a consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI). J Cardiovasc Magn Reson. 19(1):75, 2017
                                                                                              3. Greulich S et al: Myocardial inflammation-are we there yet? Curr Cardiovasc Imaging Rep. 8(3):6, 2015
                                                                                              4. Ferreira VM et al: Native T1-mapping detects the location, extent and patterns of acute myocarditis without the need for gadolinium contrast agents. J Cardiovasc Magn Reson. 16:36, 2014
                                                                                              5. Luetkens JA et al: Acute myocarditis: multiparametric cardiac MR imaging. Radiology. 273(2):383-92, 2014
                                                                                              6. Grün S et al: Long-term follow-up of biopsy-proven viral myocarditis: predictors of mortality and incomplete recovery. J Am Coll Cardiol. 59(18):1604-15, 2012
                                                                                              7. Friedrich MG et al: Cardiovascular magnetic resonance in myocarditis: a JACC White Paper. J Am Coll Cardiol. 53(17):1475-87, 2009
                                                                                              8. Dambrin G et al: Diagnostic value of ECG-gated multidetector computed tomography in the early phase of suspected acute myocarditis. A preliminary comparative study with cardiac MRI. Eur Radiol. 17(2):331-8, 2007
                                                                                              9. Mahrholdt H et al: Presentation, patterns of myocardial damage, and clinical course of viral myocarditis. Circulation. 114(15):1581-90, 2006
                                                                                              10. Abdel-Aty H et al: Diagnostic performance of cardiovascular magnetic resonance in patients with suspected acute myocarditis: comparison of different approaches. J Am Coll Cardiol. 45(11):1815-22, 2005
                                                                                              11. Liu PP et al: Cardiovascular magnetic resonance for the diagnosis of acute myocarditis: prospects for detecting myocardial inflammation. J Am Coll Cardiol. 45(11):1823-5, 2005
                                                                                              12. Roditi GH et al: MRI changes in myocarditis--evaluation with spin echo, cine MR angiography and contrast enhanced spin echo imaging. Clin Radiol. 55(10):752-8, 2000
                                                                                              13. Friedrich MG et al: Contrast media-enhanced magnetic resonance imaging visualizes myocardial changes in the course of viral myocarditis. Circulation. 97(18):1802-9, 1998
                                                                                              14. Alpert JS et al: Update in cardiology. Ann Intern Med. 125(1):40-6, 1996