Myocarditis and the Role of Cardiac Imaging

Area of Science:

• Cardiology
• Medical Imaging
• Biomedical Engineering

Background:

• Myocarditis, myocardial inflammation, presents variably, from mild symptoms to severe outcomes.
• Endomyocardial biopsy (EMB) is invasive with limited sensitivity, prompting a shift to non-invasive methods.
• Cardiovascular magnetic resonance (CMR) is increasingly vital for myocarditis diagnosis.

Purpose of the Study:

• To review the role of imaging, especially CMR, in diagnosing and managing myocarditis.
• To highlight advancements in CMR techniques for myocardial assessment.
• To discuss emerging technologies for improved myocarditis prognostication.

Main Methods:

• Review of current literature on myocarditis diagnosis and imaging.
• Emphasis on cardiovascular magnetic resonance (CMR) techniques: T1/T2 mapping and late gadolinium enhancement (LGE).
• Discussion of the 2018 Lake Louise Criteria and emerging radiomics/machine learning applications.

Main Results:

• CMR offers high sensitivity and specificity for myocarditis diagnosis.
• T1/T2 mapping quantifies myocardial edema and injury; LGE identifies necrosis/scar.
• The 2018 Lake Louise Criteria, integrating mapping, enhance diagnostic accuracy.

Conclusions:

• CMR is central to myocarditis diagnosis and management.
• Advanced CMR techniques provide critical insights into myocardial tissue characteristics.
• Future innovations, including radiomics, promise enhanced diagnostic precision and patient outcomes.