PMID- 26576638 OWN - NLM STAT- MEDLINE DCOM- 20160707 LR - 20240117 IS - 1532-429X (Electronic) IS - 1097-6647 (Print) IS - 1097-6647 (Linking) VI - 17 DP - 2015 Nov 17 TI - Cardiovascular magnetic resonance techniques and findings in children with myocarditis: a multicenter retrospective study. PG - 96 LID - 10.1186/s12968-015-0201-6 [doi] LID - 96 AB - BACKGROUND: Cardiovascular magnetic resonance (CMR) is increasingly used to diagnose myocarditis in adults but its use in children is not well-established. We sought to describe the presentation, CMR protocol and findings, and outcomes in a multicenter cohort of children with myocarditis. METHODS: Thirteen hospitals retrospectively identified patients meeting the following inclusion criteria: 1) diagnosis of myocarditis by the managing physicians, 2) age <21 years, 3) CMR examination within 30 days of presentation, and 4) no congenital heart disease. Clinical data and test results, including CMR findings, were abstracted from the medical record. RESULTS: For the 143 patients meeting inclusion criteria, the median age was 16.0 years (range, 0.1-20.3) and 139 (97 %) were hospitalized at the time of CMR. The median time from presentation to CMR was 2 days (0-28). The median left ventricular ejection fraction at CMR was 56 % (10-74), with 29 (20 %) below 45 %. The median right ventricular ejection fraction was 54 % (15-72), with 11 (8 %) below 40 %. There was significant variability among centers in the types of tissue characterization techniques employed (p < 0.001). Overall, late gadolinium enhancement (LGE) was used in 100 % of studies, followed by T2-weighted imaging (T2W) in 69 %, first-pass contrast perfusion (FPP) in 48 %, and early gadolinium enhancement (EGE) in 28 %. Abnormalities were most common with LGE (81 %), followed by T2W (74 %), EGE (55 %), and FPP (8 %). The CMR study was interpreted as positive for myocarditis in 117 patients (82 %), negative in 18 (13 %), and equivocal in 7 (5 %), yielding a sensitivity of 82 %. At a median follow-up of 7.1 months (0-87), all patients were alive and 5 had undergone cardiac transplantation. CMR parameters at presentation associated with persistent left ventricular dysfunction were larger left ventricular end-diastolic volume and lower left and right ventricular ejection fraction but not abnormal LGE. CONCLUSIONS: Despite significant practice variation in imaging protocol among centers, CMR had a high sensitivity for the diagnosis of myocarditis in pediatric patients. Abnormalities were most often seen with LGE followed by T2W, EGE, and FPP. These findings should be useful in designing future prospective studies. FAU - Banka, Puja AU - Banka P AD - Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA. puja.banka@cardio.chboston.org. FAU - Robinson, Joshua D AU - Robinson JD AD - Ann & Robert H Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, IL, USA. jdrobinson@luriechildrens.org. FAU - Uppu, Santosh C AU - Uppu SC AD - Mount Sinai Hospital and Icahn School of Medicine, New York, NY, USA. santosh.uppu@mssm.edu. FAU - Harris, Matthew A AU - Harris MA AD - Children's Hospital of Philadelphia and Perelman School of Medicine, Philadelphia, PA, USA. harrismat@email.chop.edu. FAU - Hasbani, Keren AU - Hasbani K AD - Advocate Children's Hospital, Park Ridge, IL, USA. khasbani@yahoo.com. FAU - Lai, Wyman W AU - Lai WW AD - Morgan Stanley Children's Hospital of NewYork-Presbyterian and Columbia College of Physicians and Surgeons, New York, NY, USA. wl2269@cumc.columbia.edu. FAU - Richmond, Marc E AU - Richmond ME AD - Morgan Stanley Children's Hospital of NewYork-Presbyterian and Columbia College of Physicians and Surgeons, New York, NY, USA. mr2306@cumc.columbia.edu. FAU - Fratz, Sohrab AU - Fratz S AD - Deutsches Herzzentrum Munchen, Munich, Germany. fratz@dhm.mhn.de. FAU - Jain, Supriya AU - Jain S AD - Maria Fareri Children's Hospital at Westchester Medical Center and New York Medical College, Valhalla, NY, USA. supr008@gmail.com. FAU - Johnson, Tiffanie R AU - Johnson TR AD - Riley Hospital for Children and Indiana University school of Medicine, Indianapolis, IN, USA. tifjohns@iu.edu. FAU - Maskatia, Shiraz A AU - Maskatia SA AD - Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA. samaskat@bcm.edu. FAU - Lu, Jimmy C AU - Lu JC AD - C. S. Mott Children's Hospital and University of Michigan Medical School, Ann Arbor, MI, USA. jimmyl@med.umich.edu. FAU - Samyn, Margaret M AU - Samyn MM AD - Children's Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee, WI, USA. msamyn@chw.org. FAU - Patton, David AU - Patton D AD - Alberta Children's Hospital and University of Calgary, Calgary, AB, Canada. david.patton@albertahealthservices.ca. FAU - Powell, Andrew J AU - Powell AJ AD - Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA. Andrew.powell@cardio.chboston.org. LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20151117 PL - England TA - J Cardiovasc Magn Reson JT - Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance JID - 9815616 RN - 0 (Contrast Media) SB - IM MH - Adolescent MH - Age Factors MH - Child MH - Child, Preschool MH - Contrast Media MH - Heart Transplantation MH - Hospitalization MH - Humans MH - Infant MH - *Magnetic Resonance Imaging MH - Myocarditis/*diagnosis/pathology/physiopathology/surgery MH - Myocardium/*pathology MH - Observer Variation MH - Predictive Value of Tests MH - Prognosis MH - Reproducibility of Results MH - Retrospective Studies MH - *Stroke Volume MH - Time Factors MH - *Ventricular Function, Left MH - *Ventricular Function, Right MH - Young Adult PMC - PMC4650339 EDAT- 2015/11/19 06:00 MHDA- 2016/07/09 06:00 PMCR- 2015/11/17 CRDT- 2015/11/19 06:00 PHST- 2015/05/14 00:00 [received] PHST- 2015/11/02 00:00 [accepted] PHST- 2015/11/19 06:00 [entrez] PHST- 2015/11/19 06:00 [pubmed] PHST- 2016/07/09 06:00 [medline] PHST- 2015/11/17 00:00 [pmc-release] AID - S1097-6647(23)00921-3 [pii] AID - 201 [pii] AID - 10.1186/s12968-015-0201-6 [doi] PST - epublish SO - J Cardiovasc Magn Reson. 2015 Nov 17;17:96. doi: 10.1186/s12968-015-0201-6.