Δημοσίευση

T(1) mapping for the diagnosis of acute myocarditis using CMR: comparison to T2-weighted and late gadolinium enhanced imaging.

ΤίτλοςT(1) mapping for the diagnosis of acute myocarditis using CMR: comparison to T2-weighted and late gadolinium enhanced imaging.
Publication TypeJournal Article
Year of Publication2013
AuthorsFerreira, V. M., Piechnik S. K., Dall'Armellina E., Karamitsos T. D., Francis J. M., Ntusi N., Holloway C., Choudhury R. P., Kardos A., Robson M. D., Friedrich M. G., & Neubauer S.
JournalJACC Cardiovasc Imaging
Volume6
Issue10
Pagination1048-58
Date Published2013 Oct
ISSN1876-7591
Λέξεις κλειδιάAcute Disease, Adult, Case-Control Studies, Contrast Media, Edema, Cardiac, England, Female, Gadolinium DTPA, Humans, Magnetic Resonance Imaging, Cine, Male, Middle Aged, Myocarditis, Predictive Value of Tests, Prospective Studies
Abstract

OBJECTIVES: This study sought to test the diagnostic performance of native T1 mapping in acute myocarditis compared with cardiac magnetic resonance (CMR) techniques such as dark-blood T2-weighted (T2W)-CMR, bright-blood T2W-CMR, and late gadolinium enhancement (LGE) imaging.BACKGROUND: The diagnosis of acute myocarditis on CMR often requires multiple techniques, including T2W, early gadolinium enhancement, and LGE imaging. Novel techniques such as T1 mapping and bright-blood T2W-CMR are also sensitive to changes in free water content. We hypothesized that these techniques can serve as new and potentially superior diagnostic criteria for myocarditis.METHODS: We investigated 50 patients with suspected acute myocarditis (age 42 ± 16 years; 22% women) and 45 controls (age 42 ± 14 years; 22% women). CMR at 1.5-T (median 3 days from presentation) included: 1) dark-blood T2W-CMR (short-tau inversion recovery); 2) bright-blood T2W-CMR (acquisition for cardiac unified T2 edema); 3) native T1 mapping (shortened modified look-locker inversion recovery); and 4) LGE. Image analysis included: 1) global T2 signal intensity ratio of myocardium compared with skeletal muscle; 2) myocardial T1 relaxation times; and 3) areas of LGE.RESULTS: Compared with controls, patients had significantly higher global T2 signal intensity ratios by dark-blood T2W-CMR (1.73 ± 0.27 vs. 1.56 ± 0.15, p < 0.01), bright-blood T2W-CMR (2.02 ± 0.33 vs. 1.84 ± 0.17, p < 0.01), and mean myocardial T1 (1,010 ± 65 ms vs. 941 ± 18 ms, p < 0.01). Receiver-operating characteristic analysis showed clear differences in diagnostic performance. The areas under the curve for each method were: T1 mapping (0.95), LGE (0.96), dark-blood T2 (0.78), and bright-blood T2 (0.76). A T1 cutoff of 990 ms had a sensitivity, specificity, and diagnostic accuracy of 90%, 91%, and 91%, respectively.CONCLUSIONS: Native T1 mapping as a novel criterion for the detection of acute myocarditis showed excellent and superior diagnostic performance compared with T2W-CMR. It also has a higher sensitivity compared with T2W and LGE techniques, which may be especially useful in detecting subtle focal disease and when gadolinium contrast imaging is not feasible.

DOI10.1016/j.jcmg.2013.03.008
Alternate JournalJACC Cardiovasc Imaging
PubMed ID24011774
Grant List088291 / / Wellcome Trust / United Kingdom
090532 / / Wellcome Trust / United Kingdom
G0700796 / / Medical Research Council / United Kingdom
G0900883 / / Medical Research Council / United Kingdom

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