CTICasesCardiac Sarcoidosis
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Imaging findings
Cardiac MRI demonstrates bulky, pronounced mediastinal and hilar lymphadenopathy. Delayed enhancement sequences and phase-sensitive inversion recovery images reveal heterogeneous, diffuse, and patchy myocardial enhancement, particularly infiltrating the basal segment of the left ventricle.
Key takeaways
Cardiac sarcoidosis is highly heterogeneous on delayed-enhancement MRI, manifesting as mid-myocardial or epicardial patchy enhancement that does not follow a specific coronary vascular territory. It often leads to restrictive or dilated cardiomyopathy, conduction abnormalities, and decreased ejection fraction. The diagnosis is strongly supported by the presence of characteristic bulky thoracic lymphadenopathy or systemic biopsy-proven sarcoidosis.
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