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Fig. 6 | European Journal of Hybrid Imaging

Fig. 6

From: Discrepancy between significant fibrosis and active inflammation in patients with cardiac sarcoidosis: combined and image fusion analysis of cardiac magnetic resonance and 18F fluorodeoxyglucose positron emission tomography

Fig. 6

Three representative cases of CMR, FDG, and image fusion are shown. a 60-year-old female who had advanced heart failure with reduced cardiac function (EF = 30%) showed extensive LGE and dyskinetic-thinned wall in lateral. LGE volume, CMV, mismatch volume, and CMA were 45 mL, 10 mL, − 35.7 mL, and 32. FDG showed significant uptake in the area of positive LGE, and SUVmax value highest in the posterior edge of LGE site (segmental SUVmax = 6.2, LGE%wall = 54), while lower value of SUVmax = 3.4 was observed in dyskinetic lateral wall (LGE%wall = 96). b 54-year-old female with impaired cardiac function with sustained VT. CMR showed extensive LGE around basal area and significant FDG uptake (SUVmax = 9.6). LGE volume, CMV, mismatch volume, and CMA were 28.9 mL, 90.6 mL, 62 mL, and 345. Under fusion-guided analysis, basal antero-septal segment with high-grade fibrosis showed significant uptake (SUVmax 6.5). However, higher uptake (SUVmax = 9.5) was observed in basal septum and anterolateral wall which showed LGE%wall = 59. T2-weighted image showed high intensity in the antero-basal wall. c 66-year-old female who had systemic sarcoidosis. Her ejection fraction was slightly lower (LVEF = 47%). She was pointed out with premature ventricular contraction and driven for CMR. Short axis cine showed almost normal wall motion and volume in LV. However, posterior wall was remarkably thickened and with mild hyper-enhancement in LGE image (LGE%wall = 10%). In CMR-FDG fusion, significant focal FDG uptake (SUVmax = 16.6) was observed. T2 weighted image showed no abnormality. LGE volume was remarkably smaller than CMV (LGE volume, CMV, mismatch volume, and CMA were 14.6 mL, 155.4 mL, 170 mL, and 639)

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