Multimodality Imaging in Inflammatory Cardiac Disease

Area of Science:

• Cardiology
• Medical Imaging
• Inflammatory Diseases

Background:

• Inflammatory cardiac diseases encompass myocarditis, cardiac sarcoidosis (CS), infective endocarditis (IE), and pericarditis.
• These conditions share a need for accurate diagnosis and effective management strategies.

Purpose of the Study:

• To review the definitions, epidemiology, and pathophysiology of inflammatory cardiac diseases.
• To outline the roles and diagnostic performance of various imaging modalities.
• To provide practical guidance on diagnosis and management.

Main Methods:

• Echocardiography (transthoracic/transesophageal) as first-line imaging.
• Cardiac magnetic resonance imaging (MRI) for tissue characterization.
• Computed tomography (CT) for anatomical detail.
• Fluorodeoxyglucose-positron emission tomography/CT (FDG-PET/CT) for active inflammation detection.
• Review of updated Lake Louise Criteria and hybrid imaging techniques.

Main Results:

• Each imaging modality (echocardiography, MRI, CT, PET/CT) has unique strengths and limitations.
• Multimodality imaging, including advanced techniques like T1/T2 mapping and PET suppression, improves diagnostic sensitivity.
• Updated criteria enhance the ability to diagnose and guide therapy for inflammatory cardiac conditions.

Conclusions:

• Multimodality imaging is essential for diagnosing and managing inflammatory cardiac diseases.
• Understanding the specific applications and limitations of each imaging technique is crucial.
• Advances in imaging and criteria improve patient outcomes and guide therapeutic decisions.