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3.0T Cardiac MR with MultiTransmit in myocarditis

Case Study
Thomas, Daniel, M.D., Ph.D. University of Bonn • Germany

Patient history

45-year-old male with shortness of breath and chest pain for three days. He was treated for tonsillitis with antibiotics for one week. Laboratory results revealed elevated cardiac biomarkers (Troponin I 19.1 ng/ml, CK-MB 53 µg/l) and infection parameters (WBC 15.68 G/l, CRP 95.6 mg/l). Coronary angiography showed no significant coronary artery disease.

MR examination

3.0T MultiTransmit was used with 6-channel SENSE Cardiac coil.

B-FFE (SSFP) cine was done with FOV 360 mm, matrix 160 x 144, slice thickness 8 mm, flip angle 45°, TR 2.7 ms, TE 1.4 ms.


PD TSE was done with FOV 320 mm, matrix 228 x 166, slice thickness 8 mm, TR 2400 ms, TE 10 ms.

Images

 B-FFE cine horizontal long axis B-FFE cine short axis
B-FFE cine horizontal long axis
B-FFE cine short axis



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 PDW PDW zoomed
PDW
PDW zoomed


B-FFE cine images helped to visualize discrete hypokinesis of the left lateral free wall. Note the excellent signal homogeneity across the entire field of view in these 3.0T B-FFE cine images acquired with MultiTransmit.

PD-weighted images show focal edematous spots in the left midventricular and apical left lateral free wall. MultiTransmit delivers uniform image contrast across the whole field of view.

Diagnosis

Cardiac MRI helped to confirm the diagnosis of myocarditis with focal patchy necroses.

After immediate introduction of the adequate treatment the patient did well. After 3 months the initial symptoms, dyspnea and chest pain, recovered completely.  

Clinical value of cardiac MR with MultiTransmit

Cardiac MRI helped to confirm the clinically suspected diagnosis myocarditis. The MultiTransmit technique is a major step forward in high field cardiac MRI, because it provides a  more uniform image contrast for both SSFP and PD TSE imaging.



Related readings:


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Dec 7, 2011

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Case Study
3.0T, Cardiac, MultiTransmit, myocarditis
 

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