Skip to main content

Table 1 Information provided by various CMR techniques applied in the evaluation of acute myocarditis, with main imaging features

From: Lights and shadows of cardiac magnetic resonance imaging in acute myocarditis

CMR technique

Information provided

Imaging features


Regional and global biventricular function, ventricular mass, and parietal wall thickness

- Normal or mildly dilated left or biventricular cavities

- Ejection fraction depending on clinical presentation, usually mildly depressed (45–50 %)

- Parietal wall thickness normal or slightly increased (>10 mm)

- Pericardial effusion in 30–50 % of cases


Increased myocardial free water content

- Subepicardial or patchy areas of high signal intensity following LGE distribution

- Global hyperintensity compared to skeletal muscle (T2 ratio > 1.9 according to LLc)

Pre- and post-Gd T1w FSE

Myocardial hyperemia and expansion of extracellular compartment

- Sequences frequently affected by severe artefacts

- Myocardial hyper-enhancement compared to skeletal muscle (EGEr > 4 according to LLc)

Delayed enhancement

Myocardial necrosis, scars

- No enhancement

- Focal subepicardial enhancement typically involving inferolateral LV wall

- Patchy or longitudinal striae of mid-wall enhancement

Native T1 mapping

Pixel-by-pixel assessment of T1-rt revealing myocardial changes, first of all oedema

- T1-rt prolongation: proposed cut-off > 990 ms (59)

Pre- and post-Gd T1 mapping

ECV expansion due to enhanced diffusion of free water and cardiomyocyte apoptosis

- ECV increase: proposed cut-off ≥ 27 %; still few published data (34)

T2 mapping

Pixel-by-pixel assessment of T2-rt revealing myocardial oedema

- T2-rt prolongation; still few published data (64)

  1. CMR cardiovascular magnetic resonance, SSFP steady-state free precession, T2w-STIR T2-weighted short-tau inversion recovery, FSE fast spin echo, Gd gadolinium, T1-rt T1 relaxation time, ECV extracellular volume, T2-rt T2 relaxation time, LGE late gadolinium enhancement, LLc Lake Louise criteria, EGEr early gadolinium enhancement ratio, LV left ventricle