Cardiac MRI Evaluation of Myocarditis

Purpose of review Cardiac MRI (CMR) is the non-invasive test of choice for the assessment of myocarditis. In 2009, the Lake Louise Criteria for the diagnosis of myocarditis using CMR were first released. The decade since that time has vastly improved our understanding of CMR’s strengths and limitations. Traditional CMR methods including T2-weighted imaging and late gadolinium enhancement have proven their diagnostic value, but diagnostic performance is dependent on patient presentation. Recent findings Newer parametric mapping techniques have begun to be more comprehensively studied and may improve diagnostic accuracy of CMR in an expanded set of clinical scenarios. Additionally, the prognostic value of CMR has begun to solidify. These advances culminated in an update to the Lake Louise Criteria at the end of 2018. Summary In this review, we discuss the evolution of the diagnostic criteria for CMR in the assessment of myocarditis. We also discuss the pathophysiologic premises behind the use of specific MRI sequences and an up-to-date summary of their individual utility.