PMID- 24954462
OWN - NLM
STAT- MEDLINE
DCOM- 20150615
LR  - 20221222
IS  - 1876-7591 (Electronic)
IS  - 1876-7591 (Linking)
VI  - 7
IP  - 7
DP  - 2014 Jul
TI  - CMR in patients with severe myocarditis: diagnostic value of quantitative tissue 
      markers including extracellular volume imaging.
PG  - 667-75
LID - S1936-878X(14)00296-4 [pii]
LID - 10.1016/j.jcmg.2014.02.005 [doi]
AB  - OBJECTIVES: This study evaluated the accuracy of T2, T1, and extracellular volume 
      (ECV) quantification as novel quantitative tissue markers in comparison with 
      standard "Lake-Louise" cardiac magnetic resonance (CMR) criteria to diagnose 
      myocarditis. BACKGROUND: Novel approaches using T2 and T1 mapping may overcome 
      the limitations of signal intensity-based parameters, which would potentially 
      result in a better diagnostic accuracy compared with standard CMR techniques 
      in suspected myocarditis. METHODS: CMR was performed in 104 patients with 
      myocarditis and 21 control subjects at 1.5-T. Patients with myocarditis underwent 
      CMR 2 weeks (interquartile range: 1 to 7 weeks) after presentation with new-onset 
      heart failure (n = 66) or acute chest pain (n = 38). T2 and T1 mapping were 
      implemented into a standard protocol including T2-weighted (T2w), early 
      gadolinium enhancement (EGE) CMR, and late gadolinium enhancement (LGE) CMR. 
      T2 quantification was performed using a free-breathing, navigator-gated multiecho 
      sequence. T1 quantification was performed using the modified Look-Locker 
      inversion recovery sequence before and after administration of 
      0.075 mmol/kg gadobenate dimeglumine. T2, T1, and ECV maps were generated using a 
      plug-in for the OsiriX software (Pixmeo, Bernex, Switzerland) to calculate mean 
      global myocardial T2, T1, and ECV values. RESULTS: The diagnostic accuracies of 
      conventional CMR were 70% (95% confidence interval [CI]: 61% to 77%) for T2w CMR, 
      59% (95% CI: 56% to 73%) for EGE, and 67% (95% CI: 59% to 75%) for LGE. The 
      diagnostic accuracies of mapping techniques were 63% (95% CI: 53% to 73%) for 
      myocardial T2, 69% (95% CI: 60% to 76%) for native myocardial T1, and 76% (95% 
      CI: 68% to 82%) for global myocardial ECV. The diagnostic accuracy of CMR was 
      significantly improved to 90% (95% CI: 84% to 95%) by a stepwise approach, using 
      the presence of LGE and myocardial ECV >/=27% as diagnostic criteria, compared with 
      79% (95% CI: 71% to 85%; p = 0.0043) for the Lake-Louise criteria. CONCLUSIONS: 
      In patients with clinical evidence for subacute, severe myocarditis, ECV 
      quantification with LGE imaging significantly improved the diagnostic accuracy of 
      CMR compared with standard Lake-Louise criteria.
CI  - Copyright (c) 2014 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Radunski, Ulf K
AU  - Radunski UK
AD  - University Heart Center, General and Interventional Cardiology, University 
      Medical Center Hamburg-Eppendorf, Hamburg, Germany.
FAU - Lund, Gunnar K
AU  - Lund GK
AD  - Department of Diagnostic and Interventional Radiology, University Medical Center 
      Hamburg-Eppendorf, Hamburg, Germany.
FAU - Stehning, Christian
AU  - Stehning C
AD  - Philips Research, Hamburg, Germany.
FAU - Schnackenburg, Bernhard
AU  - Schnackenburg B
AD  - Philips Healthcare Germany, Hamburg, Germany.
FAU - Bohnen, Sebastian
AU  - Bohnen S
AD  - University Heart Center, General and Interventional Cardiology, University 
      Medical Center Hamburg-Eppendorf, Hamburg, Germany.
FAU - Adam, Gerhard
AU  - Adam G
AD  - Department of Diagnostic and Interventional Radiology, University Medical Center 
      Hamburg-Eppendorf, Hamburg, Germany.
FAU - Blankenberg, Stefan
AU  - Blankenberg S
AD  - University Heart Center, General and Interventional Cardiology, University 
      Medical Center Hamburg-Eppendorf, Hamburg, Germany.
FAU - Muellerleile, Kai
AU  - Muellerleile K
AD  - University Heart Center, General and Interventional Cardiology, University 
      Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: 
      ka.muellerleile@uke.de.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140618
PL  - United States
TA  - JACC Cardiovasc Imaging
JT  - JACC. Cardiovascular imaging
JID - 101467978
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
CIN - JACC Cardiovasc Imaging. 2014 Jul;7(7):676-8. PMID: 25034917
CIN - JACC Cardiovasc Imaging. 2015 Jan;8(1):109-10. PMID: 25592701
CIN - JACC Cardiovasc Imaging. 2015 Jan;8(1):110. PMID: 25592702
MH  - Adult
MH  - Edema, Cardiac/diagnosis
MH  - Female
MH  - Gadolinium
MH  - Humans
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - Myocarditis/*diagnosis
OTO - NOTNLM
OT  - T1 mapping
OT  - T2 mapping
OT  - cardiac magnetic resonance
OT  - extracellular volume
OT  - myocarditis
EDAT- 2014/06/24 06:00
MHDA- 2015/06/16 06:00
CRDT- 2014/06/24 06:00
PHST- 2013/10/31 00:00 [received]
PHST- 2014/02/14 00:00 [revised]
PHST- 2014/02/18 00:00 [accepted]
PHST- 2014/06/24 06:00 [entrez]
PHST- 2014/06/24 06:00 [pubmed]
PHST- 2015/06/16 06:00 [medline]
AID - S1936-878X(14)00296-4 [pii]
AID - 10.1016/j.jcmg.2014.02.005 [doi]
PST - ppublish
SO  - JACC Cardiovasc Imaging. 2014 Jul;7(7):667-75. doi: 10.1016/j.jcmg.2014.02.005. 
      Epub 2014 Jun 18.