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, Les myocardites aigües immuno-induites (MII) sont des complications rares mais fatales des inhibiteurs des checkpoints immunitaires (ICI), devant faire considérer l'arrêt de l'immunothérapie si confirmée. Les myocardites aigües virales (MV), bien plus fréquentes, n'ont pas cet impact oncologique. L'examen diagnostique non invasif de référence des myocardites aigües
, Le but de cette étude était de comparer les caractéristiques IRM des MII et des MV
,
, Le groupe MII comprenait les MA confirmées survenant chez des patients sous ICI et comptait 18 patients (14 hommes ; âge moyen 67 ± 11 ans). Le groupe MV comprenait toutes les autres MA (22 hommes ; âge moyen 35 ± 15 ans). Ces deux groupes ont été analysés sur les paramètres IRMc comprenant notamment les caractéristiques de rehaussement tardif (RT), le T1 mapping natif et après injection ainsi que la fraction de volume extra-cellulaire, MA confirmées selon les critères IRM de Lake-Louise 2018 ont été incluses de mai 2017 à mai 2020 dans cette étude monocentrique rétrospective
, Parmi les 46 patients évalués, la distribution du RT était significativement différent entre les deux groupes avec plus d'atteinte sous-épicardique dans le groupe MV retrouvée chez 27 patients (96%)
, En étude segmentaire, les MV présentaient significativement plus de RT en inféro-latéral (p=0.0001-0.01) alors que les MII atteignaient préférentiellement le septum
MV se distinguent en terme de distribution et de RT, avec une atteinte préférentiellement inférieure et latérale pour les MV contre septale pour les MII. Les MII présentent plus de RT intra-myocardique que les MV qui ,
, Mots-clés : myocardite aigüe virale, myocardite aigüe immuno-induite, IRM cardiaque, rehaussement tardif, cartographie mapping