November 18, 2021Radiology Cardiothoracic Imaging79 citationsOpen Access
Cardiac MRI Assessment of Nonischemic Myocardial Inflammation: State of the Art Review and Update on Myocarditis Associated with COVID-19 Vaccination
Key Result
Cardiac MRI is the primary noninvasive imaging modality for evaluating myocarditis, demonstrating typical findings of myocardial edema and late gadolinium enhancement in cases following COVID-19 vaccination.
Structured PICO
P
Population
Patients with suspected nonischemic myocardial inflammation (myocarditis), including those with COVID-19 illness or post-COVID-19 vaccination.
I
Intervention
Cardiac MRI (including T1 and T2 mapping, and late gadolinium enhancement)
Cardiac MRI, utilizing parametric mapping and late gadolinium enhancement, is essential for the noninvasive diagnosis and risk stratification of myocarditis, including emerging cases associated with COVID-19 vaccination.
Limitations
- Limited data available to indicate the pattern of myocardial injury following COVID-19 vaccination
- Lack of long-term outcome data for vaccine-associated myocarditis
- VAERS data relies on passive reporting and cannot determine causality
Abstract
Myocarditis is a nonischemic inflammatory disease of the myocardium that can be triggered by a multitude of events, including viral infection and toxins. Recently, there has been heightened interest in myocarditis given its association with COVID-19 vaccination. Timely identification of myocarditis can affect patient management and prognosis. Therefore, it is crucial for radiologists and cardiac imagers to understand the role of cardiac imaging to establish a diagnosis and inform treatment decisions. Cardiac MRI is the most important noninvasive imaging modality for evaluation of myocarditis, with typical findings of focal or diffuse myocardial edema and myocardial damage, including presence of late gadolinium enhancement. There are currently limited data available to indicate that the pattern of myocardial injury following COVID-19 vaccination is similar to other causes of myocarditis, although the severity of disease may be relatively mild. A description of the role of imaging and typical imaging features will be reviewed here, with a focus on emerging data in the setting of myocarditis after COVID-19 vaccination. Keywords: MRI, Heart, Inflammation © RSNA, 2021
Cite This Study
Tijmes et al. (Thu,) conducted a review in Myocarditis and nonischemic myocardial inflammation. Cardiac MRI was evaluated. Cardiac MRI is the primary noninvasive imaging modality for evaluating myocarditis, demonstrating typical findings of myocardial edema and late gadolinium enhancement in cases following COVID-19 vaccination.