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. 2021 Mar 4;3(2):e200628.
doi: 10.1148/ryct.2021200628. eCollection 2021 Apr.

Cardiac MRI in Suspected Acute COVID-19 Myocarditis

Julian A Luetkens  1 , Alexander Isaak  1 , Can Öztürk  1 , Narine Mesropyan  1 , Malte Monin  1 , Sefan Schlabe  1 , Matthäus Reinert  1 , Anton Faron  1 , Annkristin Heine  1 , Markus Velten  1 , Darius Dabir  1 , Christoph Boesecke  1 , Christian P Strassburg  1 , Ulrike Attenberger  1 , Sebastian Zimmer  1 , Georg D Duerr  1 , Jacob Nattermann  1
Affiliations

Cardiac MRI in Suspected Acute COVID-19 Myocarditis

Julian A Luetkens et al. Radiol Cardiothorac Imaging. .

Abstract

Keywords: COVID-19; coronavirus; myocarditis; cardiac MRI; T1 mapping; T2 mapping.

Keywords: COVID-19; T1 mapping; T2 mapping; cardiac MRI; coronavirus; myocarditis.

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Figures

None
Graphical abstract
Summary of study results. (a) Composition of imaging findings found in our study cohort. Besides signs of active pulmonary coronavirus disease 2019 (COVID- 19) infection with pneumonic infiltrates and pleural effusions, participants with suspected acute COVID-19 associated myocarditis had an impaired left ventricular function, also with patterns of stress-induced cardiomyopathy in single cases (a midventricular type of stress-induced cardiomyopathy with corresponding diastolic and systolic images is shown). As a key finding a distinct diffuse myocardial edema (detected with myocardial T1 and T2 mapping) was present in most participants. Late gadolinium enhancement lesions (white arrows) were less pronounced, especially when compared to participants with non-COVID-19 myocarditis. Late gadolinium enhancement lesions were present in the subepicardium of the lateral wall or in the basal septal midmyocardium. Some participants displayed pericardial enhancement or small pericardial effusions (see white arrows on corresponding images). All image examples are from the described study cohort of participants. (b) Column graphs with individual plotted values show distribution of quantitative myocardial MRI parameters in healthy participants and in participants with suspected acute non-COVID-19 and COVID-19 myocarditis. Distributions are given for native myocardial T1 relaxation time, myocardial T2 relaxation time, and extracellular volume fraction. Data are presented as mean with standard deviation error bars. The figure contains a free medical image from Servier (https://smart.servier.com/). * indicates significant pairwise comparison (P < .05). LVEF = left ventricular ejection fraction; ANOVA = analysis of variance; ECV = extracellular volume fraction.
Figure:
Summary of study results. (a) Composition of imaging findings found in our study cohort. Besides signs of active pulmonary coronavirus disease 2019 (COVID- 19) infection with pneumonic infiltrates and pleural effusions, participants with suspected acute COVID-19 associated myocarditis had an impaired left ventricular function, also with patterns of stress-induced cardiomyopathy in single cases (a midventricular type of stress-induced cardiomyopathy with corresponding diastolic and systolic images is shown). As a key finding a distinct diffuse myocardial edema (detected with myocardial T1 and T2 mapping) was present in most participants. Late gadolinium enhancement lesions (white arrows) were less pronounced, especially when compared to participants with non-COVID-19 myocarditis. Late gadolinium enhancement lesions were present in the subepicardium of the lateral wall or in the basal septal midmyocardium. Some participants displayed pericardial enhancement or small pericardial effusions (see white arrows on corresponding images). All image examples are from the described study cohort of participants. (b) Column graphs with individual plotted values show distribution of quantitative myocardial MRI parameters in healthy participants and in participants with suspected acute non-COVID-19 and COVID-19 myocarditis. Distributions are given for native myocardial T1 relaxation time, myocardial T2 relaxation time, and extracellular volume fraction. Data are presented as mean with standard deviation error bars. The figure contains a free medical image from Servier (https://smart.servier.com/). * indicates significant pairwise comparison (P < .05). LVEF = left ventricular ejection fraction; ANOVA = analysis of variance; ECV = extracellular volume fraction.
See this image and copyright information in PMC

References

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