Right ventricle late gadolinium enhancement in cardiac sarcoidosis: a case series
Bibliographic record
Abstract
To determine the prevalence of left and right ventricle late gadolinium enhancement in a series of patients with sarcoidosis and suspected cardiac involvement referred for cardiac MRI. Sarcoidosis is a multisystem disease characterized by infiltration of tissues by non-caseating granulomas and cardiac disease associated with arrhythmias, conduction disturbances, heart failure and death. Previous case reports have described late gadolinium enhancement (LGE) in the right ventricle (RV), however, this has been interpreted to be a rare feature of cardiac sarcoidosis. We identified a cases series of patients with sarcoidosis and evaluated the presence of LGE in the RV and LV. Patients referred for cardiac MRI with any notation of “sarcoidosis” between 2007-2010 were identified. Charts were subsequently reviewed to confirm a clinical diagnosis of sarcoidosis based on clinical history and pathology results and characteristic chest CT findings. A total of 47 patients with possible sarcoidosis were identified. Seventeen patients had confirmatory diagnosis of sarcoidosis based on tissue diagnosis or a strong clinical suspicion with characteristic CT chest findings and were included in this case-series. Of the 17 patients, 12 (71%) showed LGE in the LV myocardium and 7 (41%) showed LGE in the RV myocardium. All patients with RV involvement also had LV involvement. Five patients showed no LGE in either the LV or RV. The pattern of RV enhancement was typically transmural. RV involvement in sarcoidosis may be more common than previously appreciated and appears to and coexists with similar findings in the LV. Larger, more rigorous studies are warranted to assess the prevalence of this feature and it’s sensitivity for the diagnosis of cardiac sarcoidosis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".