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The purpose of this study was to use a single-breath-hold T2-mapping MRI sequence to evaluate the reversibility of myocardial edema in patients treated for acromegaly.Before and after treatment, 15 patients with acromegaly underwent myocardial T2 mapping with an experimental single-breath-hold black-blood fast spin-echo sequence. Myocardial T2 mapping with both a multiple-breath-hold fast spinecho sequence and the experimental sequence also was performed on 14 volunteers. T2 relaxation times were calculated with a standard linear least-squares fit applied to myocardial signal intensity. The T2 relaxation times of patients were compared with those of volunteers and correlated with levels of serum growth hormone and insulinlike growth factor 1. Left ventricular function and mass index were determined with cine MRI.T2 values before treatment were higher in patients (71 +/- 12 milliseconds) than in volunteers (55.9 +/- 3.6 milliseconds) (p = 0.0003). These T2 values in patients decreased soon after treatment (57.6 +/- 6.6 milliseconds, p = 0.0007). This reduction correlates with successful reduction of levels of serum growth hormone and insulinlike growth factor 1. In volunteers, myocardial T2 values did not vary significantly between the single-breath-hold sequence and the multiple-breath-hold fast spin-echo sequence. In patients, myocardial mass and left ventricular function did not differ significantly before and after treatment.Patients with acromegaly have increased myocardial T2 values, which decrease soon after treatment, reflecting reversible myocardial edema. T2 value is more sensitive than left ventricular mass index in the detection of early reversal of acromegalic cardiomyopathy. These results highlight the potential role of MRI in direct assessment of the tissular effects of growth hormone and insulinlike growth factor 1 and in evaluation of the efficacy of treatment.

Vignaux O ardiac involvement produces symptoms in only 5% of patients with sarcoidosis, although it has been found to be present as noncaseating granulomatous infiltration of the myocardium at autopsy in 20–50% of these patients [1]. The early initiation of corticosteroid therapy prevents malignant arrhythmia (sudden death accounts for ≤ 60% of the fatalities from cardiac sarcoidosis) and improves left ventricular function. Drawbacks of achieving a diagnosis via biopsy of a myocardial granuloma include risks associated with an invasive technique and the possibility of obtaining a false-negative specimen because of the patchy infiltration of the heart muscle. Therefore, the diagnosis is generally confirmed by histologic proof of sarcoidosis along with clinical and imaging features that are highly suggestive of cardiac involvement. The value of T2-weighted and gadopentetate dimeglumine–enhanced MRI for diagnosing cardiac sarcoidosis has been recently emphasized [2– 6], whereas the usefulness of other noninvasive imaging methods such as echocardiography and thallium myocardial scanning is limited because of either low sensitivity or specificity.

The purpose of this study was to compare dual-phase helical CT and endosonography for the diagnosis and staging of pancreatic tumors.Thirty patients with suspected pancreatic tumors underwent endosonography and dual-phase helical CT. A pathologic diagnosis was obtained in all cases with surgery (n = 23) or biopsy (n = 7), resulting in 27 neoplasms. Dual-phase helical CT and endosonographic findings were correlated with surgical and pathologic findings to determine diagnosis and resectability of pancreatic tumors.Overall diagnostic sensitivity was 92% for dual-phase helical CT and 100% for endosonography (p = .45). Overall accuracy for staging of pancreatic tumors was 93% for both dual-phase helical CT and endosonography. Overall accuracy for predicting resectability was 90% for both dual-phase helical CT and endosonography. Accuracy of predicting unresectability was 100% for dual-phase helical CT and 86% for endosonography (p.80). Differences were not considered statistically significant.Dual-phase helical CT and endoscopic sonography do not differ significantly for diagnosis and assessment of resectability of pancreatic tumors.