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Non-invasive imaging in the diagnosis of acute viral myocarditis.

Identifieur interne : 001D49 ( Main/Exploration ); précédent : 001D48; suivant : 001D50

Non-invasive imaging in the diagnosis of acute viral myocarditis.

Auteurs : RBID : pubmed:19756815

English descriptors

Abstract

Autopsy series of consecutive cases have demonstrated an incidence of myocarditis at approximately 1-10%; on the contrary, myocarditis is seriously underdiagnosed clinically. In a traditional view, the gold standard has been myocardial biopsy. However, it is generally specific but invasive and less sensitive, mostly because of the focal nature of the disease. Thus, non-invasive approaches to detect myocarditis are necessary. The traditional diagnostic tools are electrocardiography, laboratory values, especially troponin T or I, creatine kinase and echocardiography. For a long period, nuclear technique with indium-111 antimyosin antibody has been used as a diagnostic approach. In the last years, the use of this technique has declined because of radiation exposure and 48-h delay in obtaining imaging after injection to prevent blood pool effect. Thus, a non-invasive diagnostic approach without radiation and online image availability has been awaited. Cardiac magnetic resonance imaging has these promising characteristics. With this technique, it is possible to analyse inflammation, oedema and necrosis in addition to functional parameters such as left ventricular function, regional wall motion and dimensions. Thus, cardiovascular magnetic resonance imaging has emerged as the most important imaging tool in the diagnostic procedure and the review focus on this field. But there are also advances in echocardiography and computer tomography, which are described in detail.

DOI: 10.1007/s00392-009-0069-2
PubMed: 19756815

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Le document en format XML

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<name sortKey="Konstantinides, Stavros" uniqKey="Konstantinides S">Stavros Konstantinides</name>
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<name sortKey="Bode, Christoph" uniqKey="Bode C">Christoph Bode</name>
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<div type="abstract" xml:lang="en">Autopsy series of consecutive cases have demonstrated an incidence of myocarditis at approximately 1-10%; on the contrary, myocarditis is seriously underdiagnosed clinically. In a traditional view, the gold standard has been myocardial biopsy. However, it is generally specific but invasive and less sensitive, mostly because of the focal nature of the disease. Thus, non-invasive approaches to detect myocarditis are necessary. The traditional diagnostic tools are electrocardiography, laboratory values, especially troponin T or I, creatine kinase and echocardiography. For a long period, nuclear technique with indium-111 antimyosin antibody has been used as a diagnostic approach. In the last years, the use of this technique has declined because of radiation exposure and 48-h delay in obtaining imaging after injection to prevent blood pool effect. Thus, a non-invasive diagnostic approach without radiation and online image availability has been awaited. Cardiac magnetic resonance imaging has these promising characteristics. With this technique, it is possible to analyse inflammation, oedema and necrosis in addition to functional parameters such as left ventricular function, regional wall motion and dimensions. Thus, cardiovascular magnetic resonance imaging has emerged as the most important imaging tool in the diagnostic procedure and the review focus on this field. But there are also advances in echocardiography and computer tomography, which are described in detail.</div>
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<RefSource>Arch Pathol Lab Med. 1991 Apr;115(4):390-2</RefSource>
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<RefSource>Am Heart J. 1992 Aug;124(2):455-67</RefSource>
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<RefSource>Semin Nucl Med. 1995 Apr;25(2):195-201</RefSource>
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<RefSource>J Am Coll Cardiol. 1997 Nov 1;30(5):1354-9</RefSource>
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<RefSource>Clin Res Cardiol. 2010 Apr;99(4):261-3; author reply 265-6</RefSource>
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