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Cardiac Magnetic Resonance Imaging in Athletes With Clinical and Subclinical Myocarditis A-D, Athlete A with subclinical possible myocarditis was asymptomatic with normal electrocardiogram (ECG), echocardiogram, and high-sensitivity troponin findings. A, T2 mapping showing elevated T2 in basal-mid inferolateral wall in short axis view. B, late gadolinium enhancement (LGE) in the basal inferolateral wall in short axis view. C, Postcontrast steady state-free precession (SSFP) images showing contrast uptake in the basal-mid inferolateral wall in short axis view. D, LGE in the inferolateral wall in 3-chamber view. E-H, Athlete B with subclinical probable myocarditis was asymptomatic with normal ECG, normal echocardiogram, and elevated high-sensitivity troponin findings. E, T2 mapping showing elevated T2 in the anteroseptal wall in short axis view. F, LGE in the anteroseptal wall in 3-chamber view. G, T2 mapping showing elevated T2 in the anteroseptal wall in 3-chamber view. F, Postcontrast SSFP image showing pericardial effusion in short axis view. I-K, Athlete C with clinical myocarditis and chest pain, dyspnea, abnormal ECG, normal echocardiogram, and normal troponin findings. I, T2 mapping showing elevated T2 in the lateral wall short axis view. J, Postcontrast SSFP images showing contrast uptake in midlateral wall in short axis view. K, LGE in the epicardial midlateral wall in short axis view. L-N, Athlete D with clinical myocarditis, chest pain, abnormal ECG, echocardiogram, and troponin findings. L, T1 mapping showing elevated native T1 in midlateral wall in short axis view. M, T2 mapping showing elevated T2 in the midlateral wall in short axis view. N, LGE in the epicardial midlateral wall in short axis view. IR indicates inferior right view; IRP, inferior, right, posterior view; PLI, posterior, left, inferior view; SL, superior left view; SLA, superior, left, anterior view. Image courtesy of JAMA Cardiol. Published online May 27, 2021. doi:10.1001/jamacardio.2021.2065

A) Axial CT images through the mouse lungs at 7 and 14 days after intratracheal administration of bleomycin or saline (as a control), demonstrating increased lung fibrosis in the bleomycin group (white arrows). (B) CT attenuation histograms in Hounsfield units (HU) after lung segmentation demonstrate increased attenuation in the lungs in the bleomycin group than the control group (p <0.05), consistent with increasing fibrosis (n=3). (C) Representative axial PET/CT fusion images at 20 and 60 min demonstrating increased FAPI uptake in the lungs of the bleomycin group (white arrows) with no significant uptake in the control group (yellow arrows). (D) Time-activity curve of lung uptake ROI analysis demonstrating higher FAPI uptake in the lungs of the bleomycin group than the control (p < 0.05), 14 days after bleomycin (n=3). (E) Ex vivo biodistribution data of lung tissue demonstrating higher radiotracer uptake in the lungs of the bleomycin group than the control (n=3). *p<0.05, **p<0.01. Image created by CA Ferreira et al., University of Wisconsin-Madison, Madison, WI.