ABSTRACT
Purpose: To evaluate potential cardiac sequelae of COVID-19 vaccination at 2-month follow-up and relate cardiac symptoms to myocardial tissue changes on fluorodeoxyglucose (FDG) PET/MRI, blood biomarkers, health-related quality of life, and adverse outcomes. Materials and Methods: In this prospective study (ClinicalTrials.gov: NCT04967807), a convenience sample of individuals aged ≥17 years were enrolled after COVID-19 vaccination and were categorized as symptomatic myocarditis (new cardiac symptoms within 14 days of vaccination and met diagnostic criteria for acute myocarditis), symptomatic no myocarditis (new cardiac symptoms but did not meet criteria for myocarditis), and asymptomatic (no new cardiac symptoms). Standardized evaluation was performed 2 months after vaccination, including cardiac fluorine 18 FDG PET/MRI, blood biomarkers, and health-related quality of life. Statistical analysis included Kruskal-Wallis and Fisher exact tests. Results: Fifty-four participants were evaluated a median of 72 days (IQR: 42, 91) after COVID-19 vaccination, 17 symptomatic with myocarditis (36±[SD]15 years, 13 males), 17 symptomatic without myocarditis (42±12 years, 7 males), and 20 asymptomatic (45±14 years, 9 males). No participants in the symptomatic without myocarditis or asymptomatic groups had focal FDG-uptake, myocardial edema or impaired ventricular function. Two participants with symptomatic myocarditis had focal FDG-uptake, and three had high T2 on MRI. Health-related quality of life was lower in the symptomatic myocarditis group than the asymptomatic group. There were no adverse cardiac events beyond myocarditis in any participant. Conclusions: At two-month follow-up, FDG PET/MRI showed evidence of myocardial inflammation in 2/17 participants diagnosed with acute myocarditis early after COVID-19 vaccination, but not in symptomatic and asymptomatic participants without acute myocarditis.Keywords: Myocarditis, Vaccination, COVID-19, PET/MRI, Cardiac MRI, FDG-PET.
ABSTRACT
OBJECTIVE: To evaluate the performance of 1.5 T true fast imaging with steady state precession (TrueFISP) magnetic resonance imaging (MRI) sequences for the detection and characterization of pulmonary abnormalities caused by coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: In this retrospective single-center study, computed tomography (CT) and MRI scans of 20 patients with COVID-19 pneumonia were evaluated with regard to the distribution, opacity, and appearance of pulmonary lesions, as well as bronchial changes, pleural effusion, and thoracic lymphadenopathy. McNemar's test was used in order to compare the COVID-19-associated alterations seen on CT with those seen on MRI. RESULTS: Ground-glass opacities were better visualized on CT than on MRI (p = 0.031). We found no statistically significant differences between CT and MRI regarding the visualization/characterization of the following: consolidations; interlobular/intralobular septal thickening; the distribution or appearance of pulmonary abnormalities; bronchial pathologies; pleural effusion; and thoracic lymphadenopathy. CONCLUSION: Pulmonary abnormalities caused by COVID-19 pneumonia can be detected on TrueFISP MRI sequences and correspond to the patterns known from CT. Especially during the current pandemic, the portions of the lungs imaged on cardiac or abdominal MRI should be carefully evaluated to promote the identification and isolation of unexpected cases of COVID-19, thereby curbing further spread of the disease.
OBJETIVO: Avaliar o desempenho da ressonância magnética (RM) de 1,5 T true fast imaging with steady state precession (TrueFISP) para detecção e caracterização de anormalidades pulmonares causadas por doença do coronavírus 2019 (COVID-19). MATERIAIS E MÉTODOS: Neste estudo retrospectivo unicêntrico, imagens de tomografia computadorizada (TC) e RM de 20 pacientes com pneumonia COVID-19 foram avaliadas em relação a distribuição, opacidade e forma das lesões pulmonares, anormalidades brônquicas, derrame pleural e linfadenopatia torácica. O teste de McNemar foi usado para comparar os achados associados à COVID-19 na TC e na RM. RESULTADOS: As opacidades em vidro fosco foram mais bem visualizadas na TC do que na RM (p = 0,031). Não foram encontradas diferenças estatisticamente significantes entre TC e RM em relação aos outros aspectos, ou seja, visualização de consolidações e espessamento septal interlobular/intralobular, distribuição ou forma de anormalidades pulmonares, doenças brônquicas, derrame pleural ou linfadenopatia torácica. CONCLUSÃO: As anomalias pulmonares causadas pela pneumonia por COVID-19 podem ser detectadas nas sequências TrueFISP e correspondem aos padrões conhecidos da TC. Especialmente em face da pandemia atual, as porções de imagem dos pulmões na RM cardíaca ou abdominal devem ser cuidadosamente avaliadas para apoiar a identificação e o isolamento de casos inesperados de COVID-19 e, assim, conter a disseminação.