Performance of t1 and t2 mapping cardiovascular magnetic resonance to detect active myocarditis in patients with recent-onset heart failure
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Performance of t1 and t2 mapping cardiovascular magnetic resonance to detect active myocarditis in patients with recent-onset heart failure. / Bohnen, Sebastian; Radunski, Ulf K; Lund, Gunnar K; Kandolf, Reinhard; Stehning, Christian; Schnackenburg, Bernhard; Adam, Gerhard; Blankenberg, Stefan; Muellerleile, Kai.
In: CIRC-CARDIOVASC IMAG, Vol. 8, No. 6, 06.2015.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Performance of t1 and t2 mapping cardiovascular magnetic resonance to detect active myocarditis in patients with recent-onset heart failure
AU - Bohnen, Sebastian
AU - Radunski, Ulf K
AU - Lund, Gunnar K
AU - Kandolf, Reinhard
AU - Stehning, Christian
AU - Schnackenburg, Bernhard
AU - Adam, Gerhard
AU - Blankenberg, Stefan
AU - Muellerleile, Kai
N1 - © 2015 American Heart Association, Inc.
PY - 2015/6
Y1 - 2015/6
N2 - BACKGROUND: This study evaluated the performance of novel quantitative T1 and T2 mapping cardiovascular magnetic resonance (CMR) techniques to identify active myocarditis in patients with recent-onset heart failure.METHODS AND RESULTS: Thirty-one consecutive patients with recent-onset heart failure, reduced left ventricular function and clinically suspected myocarditis underwent endomyocardial biopsy and CMR at 1.5 Tesla. The CMR protocol included standard Lake-Louise parameters as well as T1 mapping using a modified Look-Locker inversion recovery sequence and T2 mapping using a hybrid gradient and spin-echo sequence. Short-axis maps were generated using an OsiriX plug-in to calculate global myocardial T1, T2, and extracellular volume fraction. Active myocarditis was defined by ongoing inflammation on endomyocardial biopsy. Endomyocardial biopsy revealed active myocarditis in 16 (52%) of 31 patients. Neither clinical characteristics, standard Lake-Louise CMR parameters, global myocardial T1 nor extracellular volume fraction differed significantly between patients with and without active myocarditis. However, median global myocardial T2 was significantly higher in patients with active myocarditis (65 ms [Q1-Q3, 61-70 ms]) than in patients without active myocarditis (59 ms [Q1-Q3, 55-64 ms]; P<0.01). A cutoff value for global myocardial T2 of ≥60 ms provided a sensitivity, specificity, accuracy, negative and positive predictive value of 94% (70%-100%), 60% (32%-84%), 77% (60%-89%), 90% (56%-100%), and 71% (48%-89%) for active myocarditis, respectively.CONCLUSIONS: T2 mapping seems to be superior when compared with standard CMR parameters, global myocardial T1, and extracellular volume fraction values for assessing the activity of myocarditis in patients with recent-onset heart failure and reduced left ventricular function.
AB - BACKGROUND: This study evaluated the performance of novel quantitative T1 and T2 mapping cardiovascular magnetic resonance (CMR) techniques to identify active myocarditis in patients with recent-onset heart failure.METHODS AND RESULTS: Thirty-one consecutive patients with recent-onset heart failure, reduced left ventricular function and clinically suspected myocarditis underwent endomyocardial biopsy and CMR at 1.5 Tesla. The CMR protocol included standard Lake-Louise parameters as well as T1 mapping using a modified Look-Locker inversion recovery sequence and T2 mapping using a hybrid gradient and spin-echo sequence. Short-axis maps were generated using an OsiriX plug-in to calculate global myocardial T1, T2, and extracellular volume fraction. Active myocarditis was defined by ongoing inflammation on endomyocardial biopsy. Endomyocardial biopsy revealed active myocarditis in 16 (52%) of 31 patients. Neither clinical characteristics, standard Lake-Louise CMR parameters, global myocardial T1 nor extracellular volume fraction differed significantly between patients with and without active myocarditis. However, median global myocardial T2 was significantly higher in patients with active myocarditis (65 ms [Q1-Q3, 61-70 ms]) than in patients without active myocarditis (59 ms [Q1-Q3, 55-64 ms]; P<0.01). A cutoff value for global myocardial T2 of ≥60 ms provided a sensitivity, specificity, accuracy, negative and positive predictive value of 94% (70%-100%), 60% (32%-84%), 77% (60%-89%), 90% (56%-100%), and 71% (48%-89%) for active myocarditis, respectively.CONCLUSIONS: T2 mapping seems to be superior when compared with standard CMR parameters, global myocardial T1, and extracellular volume fraction values for assessing the activity of myocarditis in patients with recent-onset heart failure and reduced left ventricular function.
KW - Adult
KW - Biopsy
KW - Female
KW - Heart Failure
KW - Humans
KW - Image Processing, Computer-Assisted
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Myocarditis
KW - Myocardium
KW - Reproducibility of Results
KW - Sensitivity and Specificity
KW - Clinical Trial
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1161/CIRCIMAGING.114.003073
DO - 10.1161/CIRCIMAGING.114.003073
M3 - SCORING: Journal article
C2 - 26015267
VL - 8
JO - CIRC-CARDIOVASC IMAG
JF - CIRC-CARDIOVASC IMAG
SN - 1941-9651
IS - 6
ER -
