Noninvasive imaging in acute myocarditis.

Area of Science:

• Cardiology
• Medical Imaging
• Diagnostic Techniques

Background:

• Endomyocardial biopsy, the gold standard for diagnosing acute myocarditis, carries significant risks.
• Noninvasive imaging plays a vital role in managing suspected acute myocarditis.
• This review focuses on the application of various imaging modalities in acute myocarditis.

Purpose of the Study:

• To review the role of different imaging techniques in the diagnosis and management of acute myocarditis.
• To highlight advancements in noninvasive diagnostic tools for acute myocarditis.
• To compare the efficacy of various imaging modalities in suspected acute myocarditis.

Main Methods:

• Review of current literature on noninvasive imaging techniques for acute myocarditis.
• Discussion of echocardiography, cardiovascular magnetic resonance (CMR), and 18-Fluorodeoxyglucose Positron Emission Tomography (PET).
• Evaluation of newer imaging parameters such as speckle tracking and quantitative T1/T2 mapping.

Main Results:

• Echocardiography, including strain and strain rate imaging, is an essential initial tool for assessing myocardial dysfunction.
• Cardiovascular magnetic resonance (CMR) advancements, including quantitative T1/T2 mapping and automated late gadolinium enhancement, offer improved quantification of myocardial edema and scar.
• 18-Fluorodeoxyglucose PET shows increasing utility in diagnosing myocarditis, particularly in cases associated with cardiac sarcoidosis.

Conclusions:

• Echocardiography remains the primary initial investigation for suspected myocarditis.
• Cardiovascular magnetic resonance (CMR) is a leading imaging modality due to recent technological advancements.
• The role of cardiac computed tomography in diagnosing myocarditis requires further clarification.