PMID- 24895035
OWN - NLM
STAT- MEDLINE
DCOM- 20150602
LR  - 20211021
IS  - 1432-1084 (Electronic)
IS  - 0938-7994 (Print)
IS  - 0938-7994 (Linking)
VI  - 24
IP  - 10
DP  - 2014 Oct
TI  - Assessment of sub-clinical acute cellular rejection after heart transplantation: 
      comparison of cardiac magnetic resonance imaging and endomyocardial biopsy.
PG  - 2360-71
LID - 10.1007/s00330-014-3246-2 [doi]
AB  - OBJECTIVE: Comparing the diagnostic value of multi-sequential cardiac magnetic 
      resonance imaging (CMR) with endomyocardial biopsy (EMB) for sub-clinical cardiac 
      allograft rejection. METHODS: One hundred and forty-six examinations in 73 
      patients (mean age 53 +/- 12 years, 58 men) were performed using a 1.5 Tesla system 
      and compared to EMB. Examinations included a STIR (short tau inversion recovery) 
      sequence for calculation of edema ratio (ER), a T1-weighted spin-echo sequence 
      for assessment of global relative enhancement (gRE), and inversion-recovery 
      sequences to visualize late gadolinium enhancement (LGE). Histological grade >/=1B 
      was considered relevant rejection. RESULTS: One hundred and twenty-seven 
      (127/146 = 87 %) EMBs demonstrated no or mild signs of rejection (grades </=1A) and 
      19/146 (13 %) a relevant rejection (grade >/=1B). Sensitivity, specificity, 
      positive predictive, and negative predictive values were as follows: ER: 63 %, 
      78 %, 30 %, and 93 %; gRE: 63 %, 70 %, 24 %, and 93 %; LGE: 68 %, 36 %, 13 %, and 
      87 %; with the combination of ER and gRE with at least one out of two positive: 
      84 %, 57 %, 23 %, and 96 %. ROC analysis revealed an area under the curve of 
      0.724 for ER and 0.659 for gRE. CONCLUSION: CMR parameters for myocarditis are 
      useful to detect sub-clinical acute cellular rejection after heart 
      transplantation. Comparable results to myocarditis can be achieved with a 
      combination of parameters. KEY POINTS: * Magnetic resonance imaging is useful for 
      the assessment of cardiac allograft rejection. * CMR has a high negative 
      predictive value for exclusion of allograft rejection. * Diagnostic performance 
      is not yet good enough to replace endomyocardial biopsy.
FAU - Krieghoff, Christian
AU  - Krieghoff C
AD  - Department of Diagnostic and Interventional Radiology, University Leipzig - Heart 
      Centre, Leipzig, Germany, christian.krieghoff@herzzentrum-leipzig.de.
FAU - Barten, Markus J
AU  - Barten MJ
FAU - Hildebrand, Lysann
AU  - Hildebrand L
FAU - Grothoff, Matthias
AU  - Grothoff M
FAU - Lehmkuhl, Lukas
AU  - Lehmkuhl L
FAU - Lucke, Christian
AU  - Lucke C
FAU - Andres, Claudia
AU  - Andres C
FAU - Nitzsche, Stefan
AU  - Nitzsche S
FAU - Riese, Franziska
AU  - Riese F
FAU - Struber, Martin
AU  - Struber M
FAU - Mohr, Friedrich Wilhelm
AU  - Mohr FW
FAU - Gutberlet, Matthias
AU  - Gutberlet M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20140604
PL  - Germany
TA  - Eur Radiol
JT  - European radiology
JID - 9114774
SB  - IM
MH  - Acute Disease
MH  - Allografts
MH  - Biopsy/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/*diagnosis
MH  - *Heart Transplantation
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Predictive Value of Tests
MH  - ROC Curve
MH  - Retrospective Studies
PMC - PMC4155184
EDAT- 2014/06/05 06:00
MHDA- 2015/06/03 06:00
PMCR- 2014/06/04
CRDT- 2014/06/05 06:00
PHST- 2013/11/23 00:00 [received]
PHST- 2014/05/15 00:00 [accepted]
PHST- 2014/03/31 00:00 [revised]
PHST- 2014/06/05 06:00 [entrez]
PHST- 2014/06/05 06:00 [pubmed]
PHST- 2015/06/03 06:00 [medline]
PHST- 2014/06/04 00:00 [pmc-release]
AID - 3246 [pii]
AID - 10.1007/s00330-014-3246-2 [doi]
PST - ppublish
SO  - Eur Radiol. 2014 Oct;24(10):2360-71. doi: 10.1007/s00330-014-3246-2. Epub 2014 
      Jun 4.