*Purpose: Myocarditis is an inflammatory condition characterized by myocardial edema, which is a key diagnostic criterion. The introduction of T2 mapping techniques has enabled the quantitative assessment of myocardial edema using cardiovascular magnetic resonance (CMR). This study aims to explore the demographic, laboratory, clinical, and CMR correlates of T2 mapping in patients with myocarditis
*Methods and Materials: This retrospective study included 141 consecutive patients with acute myocarditis (113 males, mean age 41.12 ± 19.64 years) who met the diagnostic criteria for clinically suspected myocarditis with an acute presentation and underwent CMR examinations fulfilling both the Lake Louise Criteria.
*Results: Patients with acute myocarditis exhibited a mean T2 mapping value of 60.12 ± 6.28 ms. Higher T2 mapping values were observed in patients with hypertension (62.38 ± 5.9 ms vs. 59.55 ± 6.27 ms; p = 0.039), impaired left ventricular ejection fraction (65.36 ± 6.4 ms vs. 58.76 ± 5.5 ms; p = 0.001), impaired longitudinal strain (60.71 ± 6.4 ms vs. 56.22 ± 3.4 ms; p = 0.002), and late gadolinium enhancement (LGE) in the septum (62.29 ± 7.1 ms vs. 59.41 ± 5.86 ms; p = 0.023). On multivariable linear regression analysis, decreased LVEF (Beta = −2.584, p = 0.014) and greater LGE extent (Beta = 2.166, p = 0.034) were independently associated with elevated T2 mapping values.
*Conclusions: In acute myocarditis, elevated T2 mapping values are strongly associated with imaging markers of disease severity. These findings highlight the value of T2 mapping in elucidating myocardial inflammation and its role in the comprehensive assessment of myocarditis
*Clinical Relevance/Application: Elevated T2 mapping values in acute myocarditis are associated with impaired cardiac function and greater myocardial damage.T2 mapping provides quantitative insights into myocardial edema, correlating with established markers of disease severity.These results support the clinical utility of T2 mapping for comprehensive CMR assessment in suspected myocarditis.

Alessandro Pinna MD

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