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Erschienen in: Der Radiologe 1/2013

01.01.2013 | Leitthema

MRT bei Myokarditis

verfasst von: Prof. Dr. M. Gutberlet, C. Lücke, C. Krieghoff, L. Hildebrand, P. Lurz, J. Steiner, J. Adam, I. Eitel, H. Thiele, M. Grotthoff, L. Lehmkuhl

Erschienen in: Die Radiologie | Ausgabe 1/2013

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Zusammenfassung

Die kardiale MRT stellt die primäre nichtinvasive bildgebende Modalität bei Verdacht auf Myokarditis dar, insbesondere auch nach Ausschluss eines akuten Koronarsyndroms (ACS) zur Differenzialdiagnose. Verschiedene MR-Parameter mit unterschiedlicher Wertigkeit stehen zur Verfügung. Die Beurteilung der Volumetrie und Ventrikelfunktion weisen ebenso wie der Nachweis eines Perikardergusses alleine nur eine geringe Sensitivität und Spezifität auf. Die spezifischeren MRT-Inflammationsparameter stellen die T2-Ratio (Ödemnachweis), die frühe Kontrastmittelanreicherung bzw. das globale relative Enhancement (gRE) und die späte Kontrastmittelanreicherung, das so genannte Late-Gadolinium-Enhancement (LGE) als Zeichen eines irreversiblen Myokardschadens dar. Alle MR-Parameter zeigen die beste diagnostische Genauigkeit bei einer „infarktähnlichen“ akuten Myokarditis und eine insgesamt schlechtere Sensitivität und Spezifität bei chronischer Myokarditis. Aus diesem Grunde sollte immer ein multisequentieller Ansatz (mindestens 2 von 3 MRT-Parametern positiv) gewählt werden. Die Beurteilung der Wertigkeit neuer quantitativer Sequenzen wie des T1- und T2-Mappings steht noch aus.
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Metadaten
Titel
MRT bei Myokarditis
verfasst von
Prof. Dr. M. Gutberlet
C. Lücke
C. Krieghoff
L. Hildebrand
P. Lurz
J. Steiner
J. Adam
I. Eitel
H. Thiele
M. Grotthoff
L. Lehmkuhl
Publikationsdatum
01.01.2013
Verlag
Springer-Verlag
Erschienen in
Die Radiologie / Ausgabe 1/2013
Print ISSN: 2731-7048
Elektronische ISSN: 2731-7056
DOI
https://doi.org/10.1007/s00117-012-2385-1

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