Interest of Cardiac MRI in the Etiological Diagnosis of Dilated Cardiomyopathies: About 45 Cases

Dilated cardiomyopathies (DCM) represent a heterogeneous group of disorders characterized by dilation and systolic impairment of the left or both ventricles. Identifying the underlying etiology is crucial for guiding management, assessing prognosis, and orienting therapeutic strategies. Cardiac magnetic resonance imaging (CMR) plays a central role thanks to its morphological, functional, and tissue characterization capabilities. Objective: To evaluate the contribution of CMR in the etiological identification of dilated cardiomyopathies. Methods: A retrospective study was conducted on 45 patients with echocardiographically documented DCM who underwent cardiac MRI. Results: CMR provided accurate assessment of ventricular function and chamber dilation. Analysis of late gadolinium enhancement (LGE) and mapping sequences contributed to distinguishing ischemic causes (15 cases) from non-ischemic forms (30 cases: myocarditis, idiopathic/genetic DCM, infiltrative etiologies). MRI also provided prognostic insights by characterizing the extent and distribution of myocardial fibrosis. Conclusion: Cardiac MRI is an essential tool in the etiological diagnosis of DCM, allowing better therapeutic orientation and risk stratification.