Comparison of 3D and 2D late gadolinium enhancement magnetic resonance imaging in patients with acute and chronic myocarditis

Figures

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  Fig. 1. Upper part: Image quality of 3D and 2D LGE datasets of patients with acute myocarditis and chronic inflammatory scars assessed on a 5- point Likert scale from 1 (= excellent image quality) to 5 (= non-diagnostic). Lower part: Short-axis 3D LGE images of three different patients with epicardial fibrosis (arrowheads). Left image demonstrates excellent image quality (= 1), middle image good image quality (= 2, subtle motion artifacts) and right image moderate image quality (= 3, inadequate myocardial nulling, fibrosis still detectable). Poor (score: 4) or non-diagnostic (score: 5) image quality was found in neither acute nor chronic datasets

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  Fig. 2. Short-axis LGE CMR images of a 23-year-old male patient with acute myocarditis. The upper panel shows basal, midventricular and apical sections from 3D LGE acquisition, the middle panel shows the same slices from 2D LGE acquisition and the lower panel shows the same slices in a T2 weighted sequence. High signal intensity in LGE images (arrowheads) indicating epicardial fibrous tissue in basal and midventricular anterolateral/inferolateral segments as well as apical lateral segment could be noted in both acquisitions with concomitant hyperintense signal in T2-weighted images

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  Fig. 3. Short-axis LGE CMR images of a 47-year-old male patient with chronic myocarditis. The upper panel shows basal, midventricular and apical sections from 3D LGE acquisition, the middle panel shows the same slices from 2D LGE acquisition and lower panel shows the same slices in a T2 weighted sequence. High signal intensity in LGE images (arrowheads) indicating epicardial fibrous tissue in basal and midventricular inferior segments could be noted in both acquisitions with no signal alterations in T2-weighted images

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  Fig. 4. Bland–Altmann plots depicting the mean difference between 3D and 2D acquisitions and corresponding limits of agreement (± 1.96 standard deviation; dotted lines) for myocardial mass, fibrous mass, and fibrous percentage in patients with acute (right) and chronic myocarditis (left)