PMID- 28987703 OWN - NLM STAT- MEDLINE DCOM- 20180507 LR - 20191210 IS - 1872-7727 (Electronic) IS - 0720-048X (Linking) VI - 95 DP - 2017 Oct TI - Early myocardial gadolinium enhancement in patients with myocarditis: Validation of "Lake Louise consensus" criteria using a single bolus of 0.1mmol/Kg of a high relaxivity gadolinium-based contrast agent. PG - 89-95 LID - S0720-048X(17)30292-9 [pii] LID - 10.1016/j.ejrad.2017.07.008 [doi] AB - OBJECTIVES: Global early gadolinium enhancement (EGE) is an accepted cardiac magnetic resonance (CMR) criterion for diagnosis of myocarditis. However, recommended enhancement thresholds are based specifically on standard-relaxivity Gd-chelates. We evaluated the performance of a high relaxivity MR contrast agent for detection of myocardial hyperemia in patients referred for endomyocardial biopsy (EMB). METHODS: We retrospectively enrolled 54 patients (mean age: 44.1 years [range=18-77years]; 72% men) with suspected myocarditis who underwent CMR and EMB within four weeks of clinical onset. CMR imaging protocol included T2-weighted short tau inversion-recovery sequence, EGE and late gadolinium enhanced (LGE) imaging. For EGE imaging, free-breathing ECG-gated turbo spin echo T1-weighted (TSE T1w) sequences were acquired before and within the first three minutes after gadobenate dimeglumine (0.1mmol/Kg) administration. The ratio (EGEr) between myocardial and musculoskeletal early enhancement was calculated. Myocardial edema, EGE and late gadolinium enhancement (LGE) were correlated with EMB results. Receiver operating characteristic (ROC) curve analysis of EGE values was applied on the overall population. RESULTS: EMB revealed myocarditis in 34/54 patients. Sensitivity, specificity and accuracy values of 0.61, 0.85 and 0.70, respectively, were obtained for a standard EGE threshold (EGEr>4.0). ROC analysis revealed an area under the curve of 0.701 for EGEr (IC95%:0.556-0.846, p=0.014) and 0.706 for absolute enhancement (IC95%:0.563-0.849, p=0.012). Sensitivity, specificity and accuracy values were 0.67, 0.80 and 0.72, respectively, for myocardial edema and 0.76, 0.75 and 0.76, respectively, for LGE. CONCLUSIONS: High relaxivity contrast agents provide comparable results to standard-relaxivity chelates for EGE assessment in diagnosing myocarditis. CI - Copyright (c) 2017 Elsevier B.V. All rights reserved. FAU - Galea, Nicola AU - Galea N AD - Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy. Electronic address: nicola.galea@gmail.com. FAU - Francone, Marco AU - Francone M AD - Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy. Electronic address: marco.francone@uniroma1.it. FAU - Fiorelli, Andrea AU - Fiorelli A AD - Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy. Electronic address: andrea.fiorelli@fastwebnet.it. FAU - Noce, Vincenzo AU - Noce V AD - Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy. Electronic address: vinc.noce@hotmail.it. FAU - Giannetta, Elisa AU - Giannetta E AD - Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy. Electronic address: elisa.giannetta@uniroma1.it. FAU - Chimenti, Cristina AU - Chimenti C AD - Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome, Rome, Italy; Cellular and Molecular Cardiology Lab, IRCCS L. Spallanzani, Rome, Italy. Electronic address: cristina.chimenti@uniroma1.it. FAU - Frustaci, Andrea AU - Frustaci A AD - Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome, Rome, Italy; Cellular and Molecular Cardiology Lab, IRCCS L. Spallanzani, Rome, Italy. Electronic address: biocard@unimi.it. FAU - Catalano, Carlo AU - Catalano C AD - Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy. Electronic address: carlo.catalano@uniroma1.it. FAU - Carbone, Iacopo AU - Carbone I AD - Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy. Electronic address: iacopo_carbone@hotmail.com. LA - eng PT - Evaluation Study PT - Journal Article DEP - 20170727 PL - Ireland TA - Eur J Radiol JT - European journal of radiology JID - 8106411 RN - 0 (Contrast Media) RN - 0 (Organometallic Compounds) RN - 15G12L5X8K (gadobenic acid) RN - 6HG8UB2MUY (Meglumine) SB - IM MH - Acute Disease MH - Adolescent MH - Adult MH - Aged MH - Consensus MH - Contrast Media/*administration & dosage MH - Female MH - Humans MH - Hyperemia/diagnosis MH - Image Enhancement/methods MH - Magnetic Resonance Angiography/methods MH - Male MH - Meglumine/administration & dosage/*analogs & derivatives MH - Middle Aged MH - Myocarditis/*diagnosis MH - Myocardium/pathology MH - Organometallic Compounds/*administration & dosage MH - ROC Curve MH - Retrospective Studies MH - Sensitivity and Specificity MH - Young Adult OTO - NOTNLM OT - Contrast agent OT - Gadobenate dimeglumine OT - Magnetic resonance imaging OT - Myocarditis OT - Relative enhancement EDAT- 2017/10/11 06:00 MHDA- 2018/05/08 06:00 CRDT- 2017/10/09 06:00 PHST- 2016/11/22 00:00 [received] PHST- 2017/05/22 00:00 [revised] PHST- 2017/07/15 00:00 [accepted] PHST- 2017/10/09 06:00 [entrez] PHST- 2017/10/11 06:00 [pubmed] PHST- 2018/05/08 06:00 [medline] AID - S0720-048X(17)30292-9 [pii] AID - 10.1016/j.ejrad.2017.07.008 [doi] PST - ppublish SO - Eur J Radiol. 2017 Oct;95:89-95. doi: 10.1016/j.ejrad.2017.07.008. Epub 2017 Jul 27.