Possibilities and prospects of modern radiological diagnosis of myocardial fibrosis

Possibilities and prospects of modern radiological diagnosis of myocardial fibrosis

R.E. Kalinin, N.A. Nizhnikova, D.I. Suchkov, I.A. Suchkov, E.V. Filippov

Ryazan State Medical University, Ryazan 

Myocardial fibrosis (MF) is an urgent issue of modern cardiology. Historically, endomyocardial biopsy was considered the "gold standard" for its diagnosis. However, actually, non-invasive methods of examination are preferable since invasiveness of biopsy and a risk of complications limit its widespread use.

Although many methods for MF diagnosis are available, many of them have not yet been widely used, and their efficacy and feasibility are understudied. To date, clear criteria for the diagnosis have not been developed. A systematic review and analysis of available data enable comparison of already known criteria and starkly illustrate MF-specific diagnostic features.

Modern radiation diagnostic methods (especially, contrast-enhanced magnetic resonance imaging with delayed assessment of paramagnetic accumulation [late gadolinium enhancement], as well as in T1 mapping mode) show high efficacy comparable to biopsy data. T1 and T2 mapping data are included in the Lake Louise criteria to detect early stages of myocarditis. This offers challenges for potential transition from invasive to non-invasive methods. In turn, this will prevent complications associated with complex manipulations.

Keywords: myocardial fibrosis, contrast-enhanced magnetic resonance imaging, contrast patterns, mapping, late gadolinium enhancement, extracellular volume, infrared spectroscopy.

For citation: Kalinin R.E., Nizhnikova N.A., Suchkov D.I., Suchkov I.A., Filippov E.V. Possibilities and prospects of modern radiological diagnosis of myocardial fibrosis. RMJ. 2025;8:42–45. DOI: 10.32364/2225-2282-2025-8-7