Cardiac imaging: myocarditis on MRI: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Cardiac imaging: myocarditis on MRI

Sample item

A 25-year-old man has chest pain after a viral illness, raised troponin and normal coronary arteries. Cardiac MRI shows myocardial oedema on T2 and patchy late gadolinium enhancement in the subepicardial lateral wall. What is the likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Acute myocarditis

Myocarditis typically shows subepicardial or midwall late enhancement with oedema, sparing the subendocardium. Infarction enhances from the endocardium outwards in a coronary territory. Amyloid shows diffuse subendocardial enhancement.

Option by option

  • A. Amyloidosis

    Amyloid shows diffuse subendocardial enhancement.

  • B. Acute myocarditis (correct)

    Correct. Subepicardial enhancement with oedema indicates myocarditis.

  • C. Hypertrophic cardiomyopathy with fibrosis

    Hypertrophic cardiomyopathy shows midwall enhancement at the septal insertion points with hypertrophy.

  • D. Subendocardial myocardial infarction

    Infarcts enhance from the subendocardium in a vascular territory.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Acute myocarditis. Myocarditis typically shows subepicardial or midwall late enhancement with oedema, sparing the subendocardium.

Why is "Amyloidosis" not the answer?

Amyloid shows diffuse subendocardial enhancement.

Why is "Hypertrophic cardiomyopathy with fibrosis" not the answer?

Hypertrophic cardiomyopathy shows midwall enhancement at the septal insertion points with hypertrophy.

Why is "Subendocardial myocardial infarction" not the answer?

Infarcts enhance from the subendocardium in a vascular territory.

What concept does this question test?

It tests Cardiac imaging: myocarditis on MRI in Radiology. Infarction enhances from the endocardium outwards in a coronary territory. Amyloid shows diffuse subendocardial enhancement.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiac imaging: myocarditis on MRI?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.