Cardiac MRI in Suspected Acute COVID-19 Myocarditis

Julian A Luetkens1, Alexander Isaak1, Can Öztürk1

  • 1Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany (J.A.L., A.I., N.M., M.R., A.F., D.D., U.A.); Quantitative Imaging Lab Bonn (QILaB) (J.A.L., A.I., N.M., M.R., A.F., D.D.); Department of Internal Medicine II - Cardiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany (C.O., S.Z.); Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany (M.M., S.S., C.B., C.P.S., J.N.); Department of Internal Medicine III-Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany (A.H.); Department of Anesthesiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany (M.V.); Department of Cardiac Surgery, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany (G.D.D.).

Insights

This study investigates cardiac MRI findings in patients with COVID-19 related myocarditis. Cardiac MRI, using T1 and T2 mapping, helps detect and assess myocardial inflammation in coronavirus patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Radiology

Background:

  • COVID-19, a novel coronavirus infection, has been associated with various cardiovascular complications.
  • Myocarditis, inflammation of the heart muscle, is a recognized but not fully understood complication of COVID-19.

Purpose of the Study:

  • To evaluate the utility of cardiac magnetic resonance imaging (cardiac MRI) in diagnosing and characterizing myocarditis in patients with COVID-19.
  • To assess the role of T1 and T2 mapping techniques in quantifying myocardial inflammation and injury.

Main Methods:

  • A cohort of patients with suspected COVID-19 related myocarditis underwent cardiac MRI.
  • Standard cine imaging, T1 mapping, and T2 mapping sequences were acquired.
  • Image analysis focused on identifying patterns of myocardial edema and fibrosis.

Main Results:

  • Cardiac MRI revealed evidence of myocardial inflammation in a significant proportion of patients with COVID-19.
  • T2 mapping showed increased T2 signal intensity, indicative of edema, in affected myocardial segments.
  • T1 mapping demonstrated altered native T1 values, suggesting myocardial injury or fibrosis.

Conclusions:

  • Cardiac MRI, particularly with T1 and T2 mapping, is a valuable tool for detecting and assessing myocarditis in the context of COVID-19.
  • These imaging techniques can help characterize the extent and nature of myocardial involvement, aiding in patient management.

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