Myocarditis in Cardiovascular Magnetic Resonance

Myocarditis is an inflammatory condition affecting the myocardium. The presentation and clinical course of myocarditis can be highly variable which makes it difficult to diagnose the disease. EMB can ascertain the diagnosis by (immuno-) histologic methods, PCR may in addition detect the presence of viral genomes which often play a pathogenic role in myocarditis. However, EMB is not often performed. CMR is a non-invasive technique that offers the possibility to analyze left ventricular function with great precision. Myocardial scars or necroses can be visualized by LGE. In myocarditis the typical pattern of LGE is epicardial or intramural. LGE in patients with myocarditis is associated with an unfavourable prognosis and an increased rate of cardiac events. In acute myocarditis T2-weighted images performed before administration of contrast agents may show myocardial oedema.