Contrast media-enhanced magnetic resonance imaging visualizes myocardial changes in the course of viral myocarditis
Contrast media-enhanced magnetic resonance imaging visualizes myocardial changes in the course of viral myocarditis
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DOI：
10.1161/01.cir.97.18.1802
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发表时间：
1998-05-12
期刊：
影响因子：
37.8
通讯作者：
Dietz, R
中科院分区：
文献类型：
--
作者：
Friedrich, MG;Strohm, O;Dietz, R
人类急性心肌炎的组织变化过程还不是很清楚。目前可用的诊断工具不能令人满意。我们检验了炎症反应是由对比增强磁共振成像（MRI）信号变化反映的假设。方法和结果-我们评估了44例有急性心肌炎症状的连续患者。19例患者符合入选标准，显示EGG改变、心肌功能降低、肌酸激酶升高、肌钙蛋白T阳性、急性病毒感染的血清学证据、排除冠心病和抗肌球蛋白血管造影阳性。我们在症状发作后的第2、7、14、28和84天对这些患者进行了研究。我们在应用0.1 mmol/kg钆之前和之后获得了ECG触发的T1加权图像。我们测量了与骨骼肌相关的左心室心肌的整体相对信号增强，并将其与18名志愿者的测量结果进行了比较。第2天患者的总体相对增强更高（4.8+/-0.3 [平均值+/-SE] vs 2.5+/-0.2; P
Background-The course of tissue changes in acute myocarditis in humans is not well understood. Diagnostic tools currently available are unsatisfactory. We tested the hypothesis that inflammation is reflected by signal changes in contrast-enhanced magnetic resonance imaging (MRI). Methods and Results-We assessed 44 consecutive patients with symptoms of acute myocarditis. Nineteen patients met the inclusion criteria revealing EGG changes, reduced myocardial function, elevated creatine kinase, positive troponin T, serological evidence for acute viral infection, exclusion of coronary heart disease, and positive antimyosin scintigraphy. We studied these patients on days 2, 7, 14, 28, and 84 after the onset of symptoms. We obtained EGG-triggered, T1-weighted images before and after application of 0.1 mmol/kg gadolinium. We measured the global relative signal enhancement of the left ventricular myocardium related to skeletal muscle and compared it with measurements in 18 volunteers. The global relative enhancement was higher in patients on days 2 (4.8+/-0.3 [mean+/-SE] versus 2.5+/-0.2; P