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CASE REPORT
Year : 2020  |  Volume : 6  |  Issue : 1  |  Page : 87-89

Noninvasive detection of cardiac transplant rejection using cardiovascular magnetic resonance: Correlation with endomyocardial biopsy


1 Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
2 Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
3 Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Priya Jagia
Room No. 10A, Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpcs.jpcs_1_20

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A heart transplant patient came for her routine annual surveillance. She received cardiac transplant in April 2017. The patient did not have any cardiovascular symptoms. Her coronary angiogram did not reveal any significant coronary artery disease. The endomyocardial biopsy showed diagnosis of acute cellular rejection, Grade 1R with antibody mediated rejection, Grade 2 and Quilty effect was made. Subsequently, panel-reactive antibody assay was performed, and it was 0% for human leukocyte antigen (HLA) Class I and 43% for HLA Class II. A noncontrast cardiac magnetic resonance imaging (MRI) (mapping sequence) was done to rule out any rejection. Cine images revealed normal biventricular function. However, mapping sequences showed diffuse abnormal increase in native T1 (average ~1200 ms) and native T2 (average ~62 ms) values in the entire myocardium. MRI T1 and T2 mapping sequences may help in early non invasive detection of rejection.


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