MAGNETIC-RESONANCE-IMAGING IN CARDIAC SAR COIDOSIS - A CASE-REPORT

The authors report the value of magnetic resonance imaging (MRI) in a case of cardiac sarcoidosis presenting with syncopal ventricular tachy cardia (VT). The images were acquired in a monomorphic multiplane echo spin sequence. A 25 millisecond interval was chosen for the weighted T1 sequence. A second weighted T2 sequence using an interval of 70 mil liseconds was then performed. The acquisitions were recorded in these planes axial, sagittal and coronal. The thickness of the sections was 8 mm. MRI was useful in locating the exact site and extent of the lesi ons; this enabled the operators to perform <<guided>> endomyocardial b iopsies. In the weighted T1 sequences, these biopsies showed zones of increased intramyocardial signal density, more pronounced on the secon d weighted T2 sequences. Moreover, it was possible to follow up the ou tcome of these lesions with steroid therapy and observe their partial regression. These non-specific appearances may be observed in all infl ammatory conditions but, in the context of systemic sarcoidosis, are v ery suggestive of cardiac involvement. In view of the clinical latency of cardiac sarcoidosis and its poor prognosis, the non-invasive chara cter of MRI should make this a routine investigation in all patients w ith systemic sarcoidosis.