Vessel wall imaging with advanced flow suppression in the characterization of intracranial aneurysms following flow diversion with Pipeline embolization device

2022 ◽  
pp. neurintsurg-2021-018086
Author(s):  
Eytan Raz ◽  
Adam Goldman-Yassen ◽  
Anna Derman ◽  
Ahrya Derakhshani ◽  
John Grinstead ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Flow Diverter ◽  
Black Blood ◽  
Gadolinium Enhancement ◽  
Parent Vessel ◽  
Post Contrast ◽  
Conventional Mri ◽  
Aneurysm Wall ◽  
Pattern Distribution ◽  
Aneurysm Occlusion

BackgroundHigh-resolution vessel wall MRI (VWI) is increasingly used to characterize intramural disorders of the intracranial vasculature unseen by conventional arteriography.ObjectiveTo evaluate the use of VWI for surveillance of flow diverter (FD) treated aneurysms.Materials and methodsRetrospective study of 28 aneurysms (in 21 patients) treated with a FD (mean 57 years; 14 female). All examinations included VWI and a contemporaneously obtained digital subtraction angiogram. Multiplanar pre- and post-gadolinium 3D, variable flip-angle T1 black-blood VWI was obtained using delay alternating nutation for tailored excitation (DANTE) at 3T. 3D time-of-flight MR angiography (MRA) was also carried out. Images were assessed for in-stent stenosis, aneurysm occlusion, presence and pattern/distribution of aneurysmal or parent vessel gadolinium enhancement.ResultsThe VWI-MRI was performed on average at 361±259 days after the intervention. Follow-up DSA was performed at 338±254 days postintervention. Good or excellent black-blood angiographic quality was recorded in 22/28 (79%) pre-contrast and 21/28 (75%) post-contrast VWI, with no cases excluded for image quality. Aneurysm enhancement was noted in 24/28 (85.7%) aneurysms, including in 79% of angiographically occluded aneurysms and 100% of angiographically non-occluded aneurysms. Enhancement of the stented parent-vessel wall occurred significantly more often when aneurysm enhancement was present (92% vs 33%, p=0.049).ConclusionAdvanced VWI produces excellent depiction of FD-treated aneurysms, with robust evaluation of the parent vessel and aneurysm wall to an extent not achievable with conventional MRI/MRA. Gadolinium enhancement may, however, continue even after enduring catheter angiographic occlusion, confounding interpretation, and requiring cognizance of this potentially prolonged effect in such patients.

Quantitative analysis of unruptured intracranial aneurysm wall thickness and enhancement using 7T high resolution, black blood magnetic resonance imaging

2021 ◽  
pp. neurintsurg-2021-017688
Author(s):  
Xinke Liu ◽  
Junqiang Feng ◽  
Zhixin Li ◽  
Zihao Zhang ◽  
Qiang Zhang ◽  
...  
Keyword(s):  
Intracranial Aneurysm ◽  
Wall Thickness ◽  
Signal Intensity ◽  
Spin Echo ◽  
Fast Spin Echo ◽  
Black Blood ◽  
Post Contrast ◽  
Isotropic Resolution ◽  
Aneurysm Size ◽  
Aneurysm Wall

BackgroundThis study was performed to quantify intracranial aneurysm wall thickness (AWT) and enhancement using 7T MRI, and their relationship with aneurysm size and type.Methods27 patients with 29 intracranial aneurysms were included. Three-dimensional T1 weighted pre‐ and post-contrast fast spin echo with 0.4 mm isotropic resolution was used. AWT was defined as the full width at half maximum on profiles of signal intensity across the aneurysm wall on pre-contrast images. Enhancement ratio (ER) was defined as the signal intensity of the aneurysm wall over that of the brain parenchyma. The relationships between AWT, ER, and aneurysm size and type were investigated.Results7T MRI revealed large variations in AWT (range 0.11–1.24 mm). Large aneurysms (>7 mm) had thicker walls than small aneurysms (≤7 mm) (0.49±0.05 vs 0.41±0.05 mm, p<0.001). AWT was similar between saccular and fusiform aneurysms (p=0.546). Within each aneurysm, a thicker aneurysm wall was associated with increased enhancement in 28 of 29 aneurysms (average r=0.65, p<0.05). Thicker walls were observed in enhanced segments (ER >1) than in non-enhanced segments (0.53±0.09 vs 0.38±0.07 mm, p<0.001).ConclusionImproved image quality at 7T allowed quantification of intracranial AWT and enhancement. A thicker aneurysm wall was observed in larger aneurysms and was associated with stronger enhancement.

scholarly journals Quantitative Susceptibility Mapping and Vessel Wall Imaging as Screening Tools to Detect Microbleed in Sentinel Headache

2020 ◽  
Vol 9 (4) ◽  
pp. 979
Author(s):  
Daizo Ishii ◽  
Daichi Nakagawa ◽  
Mario Zanaty ◽  
Jorge A. Roa ◽  
Sami Al Kasab ◽  
...  
Keyword(s):  
Predictive Value ◽  
Vessel Wall ◽  
Susceptibility Mapping ◽  
Vessel Wall Imaging ◽  
Screening Tools ◽  
Diagnostic Strategy ◽  
Quantitative Susceptibility Mapping ◽  
Post Contrast ◽  
Aneurysm Wall ◽  
Wall Imaging

Background: MR-quantitative susceptibility mapping (QSM) can identify microbleeds (MBs) in intracranial aneurysm (IA) wall associated with sentinel headache (SH) preceding subarachnoid hemorrhage. However, its use is limited, due to associated skull base bonny and air artifact. MR-vessel wall imaging (VWI) is not limited by such artifact and therefore could be an alternative to QSM. The purpose of this study was to investigate the correlation between QSM and VWI in detecting MBs and to help develop a diagnostic strategy for SH. Methods: We performed a prospective study of subjects with one or more unruptured IAs in our hospital. All subjects underwent evaluation using 3T-MRI for MR angiography (MRA), QSM, and pre- and post-contrast VWI of the IAs. Presence/absence of MBs detected by QSM was correlated with aneurysm wall enhancement (AWE) on VWI. Results: A total of 40 subjects harboring 51 unruptured IAs were enrolled in the study. MBs evident on the QSM sequence was detected in 12 (23.5%) IAs of 11 subjects. All these subjects had a history of severe headache suggestive of SH. AWE was detected in 22 (43.1%) IAs. Using positive QSM as a surrogate for MBs, the sensitivity, specificity, positive predictive value, and negative predictive value of AWE on VWI for detecting MBs were 91.7%, 71.8%, 50%, and 96.6%, respectively. Conclusions: Positive QSM findings strongly suggested the presence of MBs with SH, whereas, the lack of AWE on VWI can rule it out with a probability of 96.6%. If proven in a larger cohort, combining QSM and VWI could be an adjunctive tool to help diagnose SH, especially in cases with negative or non-diagnostic CT and lumbar puncture.

scholarly journals Relationship between aneurysm wall enhancement and conventional risk factors in patients with unruptured intracranial aneurysms: A black-blood MRI study

2016 ◽  
Vol 22 (5) ◽  
pp. 501-505 ◽  
Author(s):  
Peng Liu ◽  
Haikun Qi ◽  
Aihua Liu ◽  
Xianli Lv ◽  
Yuhua Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Logistic Regression Analysis ◽  
Black Blood ◽  
Mr Images ◽  
Post Contrast ◽  
Aneurysm Size ◽  
Aneurysm Wall ◽  
Wilcoxon Rank Sum Test ◽  
Unruptured Intracranial Aneurysms ◽  
Black Blood Imaging

Background and purpose Aneurysmal wall enhancement (AWE) has emerged as a new possible biomarker for depicting inflammation of the intracranial aneurysm (IA). However, the relationships of AWE with other risk factors are still unclear for unruptured IA. The purpose of this study was to investigate the association between AWE and other risk metrics. Methods Forty-eight patients with unruptured saccular IAs diagnosed by digital subtraction angiography were recruited to undergo magnetic resonance (MR) black-blood imaging. AWE was evaluated using the pre- and post-contrast black-blood MR images. Univariate and multivariate logistic regression analysis was performed to investigate the association of AWE with other risk factors, including size, maximal neck width, parent vessel diameter, location, multiplicity, daughter sacs and other clinical factors. The prevalence of AWE in each ISUIA grade was reported and compared by Wilcoxon rank sum test. Results In total, 61 aneurysms were detected in 48 patients. Aneurysm size was found to be an independent risk factor associated with AWE (OR 2.46 per mm increase, 95% CI 1.34–4.51; p = 0.004). Patient age was independently and inversely associated with AWE (OR 0.898 per year increase, 95% CI 0.812–0.994; p = 0.037). Higher prevalence of AWE was observed in larger aneurysms (12%, 71.4%, 100%, and 100% of ISUIA grade 1–4 IAs have AWE, respectively). Notably, 12% of small IAs (size <7 mm) exhibited AWE. The IAs with AWE had significant higher ISUIA grade than the IAs without ( p < 0.001, Wilcoxon rank sum test). Conclusions The wall enhancement in contrast-enhanced black-blood MR images was independently associated with aneurysm size in unruptured IAs. However, some small unruptured aneurysms did exhibit wall enhancement, suggesting that AWE may provide additional aneurysm instability information to improve current size-based rupture risk evaluation metrics.

Endovascular Treatment of Posterior Cerebral Artery Aneurysms With Flow Diversion: Case Series and Systematic Review

Neurosurgery ◽  
2018 ◽  
Vol 83 (4) ◽  
pp. 790-799 ◽  
Author(s):  
Adam N Wallace ◽  
Jonathan A Grossberg ◽  
Josser E Delgado Almandoz ◽  
Mudassar Kamran ◽  
Anil K Roy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cerebral Artery ◽  
Complication Rate ◽  
Posterior Cerebral Artery ◽  
Case Series ◽  
Flow Diverter ◽  
Flow Diversion ◽  
Parent Vessel ◽  
Vessel Preservation ◽  
Aneurysm Occlusion

Abstract BACKGROUND Flow diversion of posterior cerebral artery (PCA) aneurysms has not been widely reported, possibly owing to concerns regarding parent vessel size and branch vessel coverage. OBJECTIVE To examine the safety and effectiveness of PCA aneurysm flow diverter treatment. METHODS Retrospective review of PCA aneurysms treated with the Pipeline Embolization Device (PED; Medtronic Inc, Dublin, Ireland) at 3 neurovascular centers, including periprocedural complications and clinical and angiographic outcomes. Systematic review of the literature identified published reports of PCA aneurysms treated with flow diversion. Rates of aneurysm occlusion and complications were calculated, and outcomes of saccular and fusiform aneurysm treatments were compared. RESULTS Ten PCA aneurysms in 9 patients were treated with the PED. There were 2 intraprocedural thromboembolic events (20%), including 1 symptomatic infarction and 1 delayed PED thrombosis. Eight of 10 patients returned to or improved from their baseline functional status. Complete aneurysm occlusion with parent vessel preservation was achieved in 75% (6/8) of cases at mean follow-up of 16.7 mo. Eleven of 12 (92%) major branch vessels covered by a PED remained patent. Including the present study, systematic review of 15 studies found a complete aneurysm occlusion rate of 88% (30/34) and complication rate of 26% (10/38), including 5 symptomatic ischemic strokes (13%; 5/38). Fusiform aneurysms more frequently completely occluded compared with saccular aneurysms (100% vs 70%; P = .03) but were associated with a higher complication rate (43% vs 9%; P = .06). CONCLUSION The safety and effectiveness profile of flow diverter treatment of PCA aneurysms may be acceptable in select cases.

Abstract 143: Increased Contrast Enhancement of the Parent Vessel of Unruptured Intracranial Aneurysms in 7T Magnetic Resonance Imaging

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jorge A Roa ◽  
Mario Zanaty ◽  
Carlos Osorno-Cruz ◽  
Avery Pazour ◽  
Daizo Ishii ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Parent Artery ◽  
Strong Positive Correlation ◽  
Parent Vessel ◽  
Post Contrast ◽  
Aneurysm Formation ◽  
Unruptured Intracranial Aneurysms ◽  
Vessel Enhancement ◽  
Measuring Signal

Background: Aneurysm formation and growth might be explained by a local inflammatory/vasculopathic process that debilitates the wall of the parent artery. Recently, the presence of aneurysm enhancement on high-resolution vessel wall imaging (HR-VWI) has been proposed as a surrogate for vessel wall inflammation. However, no studies have correlated circumferential aneurysm wall enhancement (CAWE) and aneurysm-to-pituitary enhancement ratio (CR stalk ) on HR-VWI with parent vessel enhancement (PVE) and reference vessel enhancement (RVE). Methods: Patients with unruptured intracranial aneurysms prospectively underwent HR-VWI using 7T MRI. CAWE, CR stalk , PVE and RVE were objectively analyzed by measuring signal intensity in T1 post-contrast sequences using manual 3D co-registration and segmentation of the vessel wall. CR stalk was calculated as the ratio of post-contrast CAWE over pituitary stalk enhancement. RVE was assessed in the mid-BA for aneurysms in the anterior circulation, and the MCA (M1 segment) for posterior circulation aneurysms. Correlation statistics were performed to find any significant association between CAWE, CR stalk , PVE and RVE. Results: Nineteen patients with 20 aneurysms were included. Mean age was 68.9 ± 9.9 years old, and 16 (84.2%) were women. Pearson and Spearman coefficients’ analyses demonstrated a strong positive correlation between post-contrast CAWE and PVE (0.72 and 0.73, both P <.001), whereas the correlation between post-contrast CAWE and RVE was low (both 0.47, P =.04). A stronger correlation was found between CR stalk and post-contrast PVE (Pearson = 0.82, Spearman = 0.71, both P <.001), while the correlation between CR stalk and post-contrast RVE was negligible (Pearson = 0.33, P =.15; Spearman = 0.38, P =.09). Conclusion: This HR-VWI study shows that the parent vessel of unruptured intracranial aneurysms enhances more with contrast than vessels located in other vascular territories. This finding suggests that a local inflammatory/vasculopathic process in the wall of the parent artery may lead to aneurysm formation.

scholarly journals Clinical Significance of Intraluminal Contrast Enhancement in Patients with Spontaneous Cervical Artery Dissection: A Black-Blood MRI Study

2017 ◽  
Vol 189 (07) ◽  
pp. 624-631 ◽  
Author(s):  
Eva Coppenrath ◽  
Olga Lenz ◽  
Nora Sommer ◽  
Nina Lummel ◽  
Jennifer Linn ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Contrast Enhancement ◽  
Vessel Wall ◽  
Thrombus Formation ◽  
Brain Mri ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Black Blood ◽  
Post Contrast ◽  
Cervical Artery

Purpose Recent studies have suggested that intraluminal thrombi show contrast enhancement on carotid black-blood T1w MRI. The aim of this study was to evaluate the significance of intraluminal contrast enhancement (iCE) regarding symptom status in patients with spontaneous cervical artery dissection (sCAD). Methods 33 consecutive patients (19 men) with sCAD received a brain MRI (DIFF, T2w, T2*w, FLAIR) and a multi-sequence 3T-MRI with fat-saturated high-resolution black-blood T1w-sequences pre- and post-contrast, contrast-enhanced MR angiography and TOF images of carotid and vertebral arteries. Presence/absence of iCE, vessel occlusion and vessel wall hematoma (hyperintense in T1w pre-contrast) were analysed by two radiologists in consensus decision. Results 44 of 132 analysed vessels had a vessel wall hematoma, consistent with sCAD. In 17 of 44 dissected vessels an acute ischemic stroke was found. 16 of 17 (94.1 %) vessels ipsilateral to ischemic stroke demonstrated iCE, compared to 9 of 44 (20.4 %) dissected vessels without stroke (P< 0.001). The presence/absence of iCE resulted in a sensitivity, specificity, positive and negative predictive value and accuracy for ischemic stroke of 0.94, 0.67, 0.64, 0.95, and 0.77, respectively, and an odds ratio of 32.0. Conclusion iCE, which is suggestive of intraluminal thrombus formation, is strongly correlated with ischemic symptoms in patients with sCAD. Key points  Citation Format

Abstract 142: Quantitative Susceptibility Mapping and Vessel Wall Imaging as Screening Tool to Detect Microbleed in Sentinel Headache

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Daizo Ishii ◽  
Daichi Nakagawa ◽  
Mario Zanaty ◽  
Jorge A Roa ◽  
Sami A Kasab ◽  
...  
Keyword(s):  
Predictive Value ◽  
Vessel Wall ◽  
Severe Headache ◽  
Susceptibility Mapping ◽  
Vessel Wall Imaging ◽  
Quantitative Susceptibility Mapping ◽  
Post Contrast ◽  
Aneurysm Wall ◽  
Sensitivity Specificity ◽  
Wall Imaging

Objective: Imaging via MR-quantitative susceptibility mapping (QSM) can identify reliably microbleeds (MBs) associated with intracranial aneurysms (IAs) in subjects presenting with severe headache suggestive of sentinel headache (SH) preceding subarachnoid hemorrhage. However, its use is limited due to associated skull base bonny artifact. Vessel wall imaging (VWI) is not limited by bonny artifact and therefore could be an alternative to QSM in detecting MBs. The purpose of this study is to examine the correlation between QSM and the MR-VWI in detecting MBs associated with severe headache suggestive of SH. Methods: We performed a prospective single-center study of subjects with unruptured IAs with initial presentation of headaches. All subjects underwent evaluation using 3T-MRI protocol which included MRA, QSM, and pre- and post-contrast VWI of the IAs. Presence/absence of MBs detected by QSM was correlated with aneurysm wall enhancement (AWE) on MR-VWI. Results: In the interval of November 2017 to June 2019, a total of 40 subjects harboring 51 unruptured IAs were enrolled in the study. MBs and AWE were detected in 12 (23.5%) and 22 (43.1%) IAs, respectively. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of QSM detecting MBs associated with recent/remote SH was 100% for all, respectively. The sensitivity, specificity, PPV, and NPV of AWE on VWI for detecting MBs confirmed by QSM was 91.7%, 71.8%, 50%, and 96.6%, respectively. Conclusions: The combination of imaging findings of MR-VWI and QSM can be used reliably for detection of MBs in subjects with IAs whose presentation is suggestive of SH. If proven in larger cohort, this could eliminate the need for lumbar puncture to screen for SH in subjects with IAs presenting to the emergency department with headaches.

Abstract WP125: Accelerated 3d Isotropic High-resolution Multi-contrast Intracranial Vessel Wall MRI For Large Artery Stroke Evaluation

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Niranjan Balu ◽  
Zechen Zhou ◽  
Mahmud Mossa-basha ◽  
Chun Yuan
Keyword(s):  
Image Quality ◽  
Vessel Wall ◽  
Complex Geometry ◽  
Plaque Morphology ◽  
Black Blood ◽  
Large Artery ◽  
Step Method ◽  
Post Contrast ◽  
Isotropic Resolution ◽  
Scan Time

Introduction: Intracranial large-artery atherosclerotic disease (ICAD) is a leading cause of death and morbidity worldwide. Vessel Wall Imaging (VWI) has potential to stratify disease beyond current angiographic methods by identifying plaque morphology and components directly. Plaque component identification requires a multi-contrast black-blood protocol. High isotropic resolution is also required due to small vessels and their complex geometry and therefore typical ICAD VWI protocols require long scan times. Aim: To develop a 3D 0.5 mm isotropic multi-contrast ICAD VWI with scan time of less than 30 minutes. Methods: Experiments were carried out on a Philips Ingenia 3T scanner with 32 channel head coil. Acceleration by K-space undersampling using CUSTOM method and compressed sensing reconstruction using STEP method [1] was used to reduce scan times. The following protocol was optimized on phantoms and volunteers: Survey scan was followed by 3D TOF, T1 weighted VISTA, PD weighted DANTE [2] VISTA, SNAP [3]. After single dose gadolinium contrast injection a post-contrast T1 weighted VISTA is obtained. Protocol parameters were optimized such that total scan time is 25 mins with all scans (except survey) being 0.5mm isotropic. Results: CUSTOM acceleration factors of 4X to 5X provided good image quality. Representative image quality (pre-contrast) is shown in figure 1. Total scan time for the multi-contrast protocol was 30 minutes including patient setup time. Studies on ICAD patients are ongoing with the optimized protocol. Conclusions: Multi-contrast 3D 0.5mm isotropic resolution MRI protocol was developed to scan ICAD patients within 30 minute scan time. Acceleration tailored for VWI allowed reducing scan times from 2 hours to less than 30 minutes thereby providing a clinically usable ICAD VWI multi-contrast protocol. References: [1] Zhou Z et al, MRM 2016, [2] Li L et al, MRM 2012, [3] Wang et al, MRM 2013.

scholarly journals High-Resolution Vessel Wall Magnetic Resonance Imaging of Small Unruptured Intracranial Aneurysms

2021 ◽  
Vol 10 (2) ◽  
pp. 225
Author(s):  
Łukasz Zwarzany ◽  
Ernest Tyburski ◽  
Wojciech Poncyljusz
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Aneurysm Rupture ◽  
Resonance Imaging ◽  
Aneurysm Wall ◽  
Conventional Risk Factors

Background: We decided to investigate whether aneurysm wall enhancement (AWE) on high-resolution vessel wall magnetic resonance imaging (HR VW-MRI) coexists with the conventional risk factors for aneurysm rupture. Methods: We performed HR VW-MRI in 46 patients with 64 unruptured small intracranial aneurysms. Patient demographics and clinical characteristics were recorded. The PHASES score was calculated for each aneurysm. Results: Of the 64 aneurysms, 15 (23.4%) showed wall enhancement on post-contrast HR VW-MRI. Aneurysms with wall enhancement had significantly larger size (p = 0.001), higher dome-to-neck ratio (p = 0.024), and a more irregular shape (p = 0.003) than aneurysms without wall enhancement. The proportion of aneurysms with wall enhancement was significantly higher in older patients (p = 0.011), and those with a history of prior aneurysmal SAH. The mean PHASES score was significantly higher in aneurysms with wall enhancement (p < 0.000). The multivariate logistic regression analysis revealed that aneurysm irregularity and the PHASES score are independently associated with the presence of AWE. Conclusions: Aneurysm wall enhancement on HR VW-MRI coexists with the conventional risk factors for aneurysm rupture.

scholarly journals Cardiac involvement in COVID-19 patients: mid-term follow up by cardiovascular magnetic resonance

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Hui Wang ◽  
Ruili Li ◽  
Zhen Zhou ◽  
Hong Jiang ◽  
Zixu Yan ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Involvement ◽  
Global Longitudinal Strain ◽  
Cine Imaging ◽  
Black Blood ◽  
Healthy Controls ◽  
Term Outcome ◽  
Post Contrast

Abstract Background Coronavirus disease 2019 (COVID-19) induces myocardial injury, either direct myocarditis or indirect injury due to systemic inflammatory response. Myocardial involvement has been proved to be one of the primary manifestations of COVID-19 infection, according to laboratory test, autopsy, and cardiovascular magnetic resonance (CMR). However, the middle-term outcome of cardiac involvement after the patients were discharged from the hospital is yet unknown. The present study aimed to evaluate mid-term cardiac sequelae in recovered COVID-19 patients by CMR Methods A total of 47 recovered COVID-19 patients were prospectively recruited and underwent CMR examination. The CMR protocol consisted of black blood fat-suppressed T2 weighted imaging, T2 star mapping, left ventricle (LV) cine imaging, pre- and post-contrast T1 mapping, and late gadolinium enhancement (LGE). LGE were assessed in mixed both recovered COVID-19 patients and healthy controls. The LV and right ventricle (RV) function and LV mass were assessed and compared with healthy controls. Results A total of 44 recovered COVID-19 patients and 31 healthy controls were studied. LGE was found in 13 (30%) of COVID-19 patients. All LGE lesions were located in the mid myocardium and/or sub-epicardium with a scattered distribution. Further analysis showed that LGE-positive patients had significantly decreased LV peak global circumferential strain (GCS), RV peak GCS, RV peak global longitudinal strain (GLS) as compared to non-LGE patients (p < 0.05), while no difference was found between the non-LGE patients and healthy controls. Conclusion Myocardium injury existed in 30% of COVID-19 patients. These patients have depressed LV GCS and peak RV strains at the 3-month follow-up. CMR can monitor the COVID-19-induced myocarditis progression, and CMR strain analysis is a sensitive tool to evaluate the recovery of LV and RV dysfunction.

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