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Acute myocarditis: multiparametric cardiac MR imaging.

Julian A Luetkens1, Jonas Doerner, Daniel K Thomas

  • 1From the Departments of Radiology (J.A.L., J.D., D.K.T., D.D., J.G., A.M.S., R.H., H.S., C.P.N.), Medical Biometry (R.F.), and Cardiology (J.O.S.), University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany; and Philips Research, Hamburg, Germany (J.G., C.S.).

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Summary

Native T1 mapping shows superior diagnostic value for acute myocarditis compared to other cardiac MRI parameters. This technique offers high sensitivity and specificity, complementing existing diagnostic criteria.

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Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Biomedical Engineering

Background:

  • Acute myocarditis diagnosis relies on clinical evidence and cardiac MRI.
  • Multiparametric cardiac MRI is used for tissue characterization.
  • Native T1 relaxation time offers potential for improved diagnostic accuracy.

Purpose of the Study:

  • To evaluate the diagnostic value of 3 Tesla cardiac MRI in acute myocarditis.
  • To assess the role of native T1 relaxation times in tissue characterization.
  • To compare multiparametric MRI techniques against clinical evidence.

Main Methods:

  • Prospective study including 24 acute myocarditis patients and 42 controls.
  • Cardiac MRI parameters: T2 ratio, early gadolinium enhancement, late gadolinium enhancement, native T1 relaxation times, extracellular volume fraction.
  • Receiver operating characteristic analysis for diagnostic performance comparison.

Main Results:

  • Native T1 relaxation times were significantly longer in myocarditis patients (P < .001).
  • Native T1 mapping demonstrated superior diagnostic performance (AUC 0.94) compared to other parameters.
  • Native T1 mapping achieved 92% sensitivity and 91% specificity, comparable to Lake Louise criteria.

Conclusions:

  • Native T1 mapping is a valuable tool for diagnosing acute myocarditis.
  • Its diagnostic performance surpasses T2 ratio and early gadolinium enhancement.
  • Native T1 mapping offers higher specificity than Lake Louise criteria, enhancing diagnostic capabilities.