Abstract
Background and Aims To evaluate whether diffusion weighted imaging can assess myocardial oedema in patients with systemic lupus erythematosus (SLE).
Methods 32 patients (mean age 36±8 years) with SLE and 20 controls (mean age 47±6 years) underwent cardiac MRI at 3.0 T. Standard cine images were obtained. DWI and T2 mapping were acquired in a mid-cavity short-axis plane. Late gadolinium enhancement (LGE) images were obtained 15 min after 0.2 mmol/kg of contrast. all patient were subdivided in to late gadolinium enhancement-positive (LGE+) and LGE-negative (LGE-) group according to the presence and absence of enhancement on LGE image.
Results SLE patients had low disease activity (mean SLE disease activity index score 0.74±0.5). There were no differences in LV size or function between SLE patients and controls. Only 11 subjects had LGE. SLE LGE+ subjects had highest ADC value among the three groups. SLE LGE+ subjects had higher ADC (apparent diffusion coefficient) than LGE- subjects. SLE LGE- subjects had higher ADC than control (p<0.05). T2 value of SLE LGE+ was no significant difference with SLE LGE- subjects. Repeated measures were highly correlated by linear regression for both inter- and intraobserver analysis (both R=0.75, p<0.001). ADC mapping identifies increased in SLE patients, likely due to subclinical myocardial oedema.
Conclusions These findings suggest that even in SLE patients with inactive disease and normal cardiac function, ADC mapping as a novel quantitative and highly reproducible technique can detected low grade myocardial inflammation.
