Cardiac Magnetic Resonance Imaging in Myocarditis

Abstract

Cardiac magnetic resonance (CMR) is a non-invasive diagnostic tool to support the clinical diagnosis of myocarditis, representing an in vivo tissue characterization imaging modality. CMR imaging sequences are sensitive to the tissue changes that occur during myocardial inflammation, regardless of its etiology, offering the possibility to detect edema, hyperemia, and necrosis. The application of CMR in the setting of myocardial inflammation is indicated first of all to strengthen the clinical suspicion, to support subsequent more invasive procedures (i.e., endomyocardial biopsy), to guide the site of endomyocardial biopsy, and to suggest additional exams. Recently the CMR diagnostic criteria have been updated to increase its accuracy, including T2-based and T1-based mapping imaging, further exploring physiopathology in myocarditis.