Kernaussagen
Myokarditiden und dilatative Kardiomyopathien sind Krankheitsbilder mit großen diagnostischen Unsicherheiten. Die Myokardbiopsie hat, insbesondere in der Differenzialdiagnostik der dilatativen Kardiomyopathie, in den letzten Jahren zu einem Erkenntnisfortschritt beigetragen. Die kardiale MRT zeigt bei beiden Krankheitsentitäten typische Befunde. Idealerweise könnte in der Zukunft die invasive Myokardbiopsie durch nichtinvasive, bildgebende Verfahren ersetzt werden.
Myokardbiopsie
Bei akuter Myokarditis ist die Indikation aufgrund der hohen Spontanheilungsrate sehr restriktiv zu stellen. Bei dilatativer Kardiomyopathie trägt die Myokardbiopsie zur differenzialdiagnostischen Einordnung und spezifischen Therapie der Erkrankung bei.
Kardiale MRT
Die kardiale MRT beschreibt verschiedene morphologische und funktionelle Parameter, visualisiert und quantifiziert Komplikationen von Myokarditiden und dilatativen Kardiomyopathien und ermöglicht eine genaue Therapiekontrolle der medikamentösen Herzinsuffizienztherapie.
Die MRT-Befunde bei LGE-Technik korrelieren bei akuter Myokarditis offenbar mit denen der Myokardbiopsie, bei dilatativer Kardiomyopathie dagegen eher nicht.
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Dr. Jeanette Schulz-Menger
Franz-Volhard-Klinik, Kardiologie · Charité Campus Buch · Universitätsmedizin Berlin · Helios-Klinikum Berlin
Wiltbergstr. 50 · 13125 Berlin
Email: jeanette.schulz-menger@charite.de
Prof. Dr. Jan TorzewskiM. phil.
Universität Ulm · Abteilung Innere Medizin II
Robert-Koch-Str. 8 · 89081 Ulm
Email: jan.torzewski@uniklinik-ulm.de
