Cardiac magnetic resonance in tropical endomyocardial fibrosis
© Gulati et al; licensee BioMed Central Ltd. 2011
Published: 2 February 2011
Endomyocardial fibrosis (EMF) is a common cause of primary restrictive cardiomyopathy (RCM) in the tropics. Available studies on the role of CMR in diagnostic evaluation of EMF are confined to case reports. We describe the spectrum of CMR features in a group of patients with this disease.
To elucidate the role of CMR in the imaging evaluation of EMF and to devise diagnostic criteria for the disease.
Over a period of 5 years, 100 cases of suspected RCM were referred for CMR. All patients underwent 1.5 T MRI (Magnetom Avanto, Siemens, Germany) with standard cardiomyopathy protocol: fast spin echo T1 and T2 (fat suppressed) weighted, steady state free precession and delayed enhancement (DE) images along the axial, 4-chamber, vertical long axis and short axis planes. Criteria for diagnosis of RCM included normal sized ventricles, normal/reduced systolic function, uni-/bi-atrial enlargement, normal pericardium and absent septal bounce. Cases diagnosed as EMF on CMR were included in this retrospective study. Etiology confirmation beyond CMR was not considered necessary for this diagnosis.
EMF was the commonest cause of RCM in our series. Major diagnostic criteria of EMF on CMR include subendocardial DE and apical obliteration. Oedema and thrombus are variable findings, depending on disease severity.
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