Functional and Morphological Parameters with Tissue Characterization of Cardiovascular Magnetic Imaging in Clinically...

Area of Science:

• Cardiology
• Medical Imaging
• Diagnostic Medicine

Background:

• Cardiac magnetic resonance (CMR) is increasingly recognized for its diagnostic utility in suspected myocarditis.
• Evaluating "infarct-like myocarditis" requires precise diagnostic tools to differentiate from other cardiac conditions.
• Functional, morphological, and tissue characterization parameters are key in CMR assessments.

Purpose of the Study:

• To assess the diagnostic value of functional and morphological parameters in "infarct-like myocarditis" using CMR.
• To evaluate the role of tissue characterization in conjunction with other CMR parameters.
• To determine the effectiveness of CMR in diagnosing "infarct-like myocarditis" based on established criteria.

Main Methods:

• Retrospective case-control study including 43 patients with "infarct-like myocarditis" and 35 controls.
• Utilized a 1.5T MRI scanner with steady-state-free-precession, T2-weighted, T1-weighted, and late gadolinium enhancement (LGE) sequences.
• Applied Lake Louise consensus criteria for diagnosing acute myocarditis (≥2 of 3 criteria).

Main Results:

• CMR demonstrated a diagnostic sensitivity, specificity, and accuracy of 67%, 100%, and 82% respectively for "infarct-like myocarditis".
• Late gadolinium enhancement (LGE) alone showed the highest sensitivity (86%) with 100% specificity and 92% accuracy.
• Functional parameters like reduced ejection fraction (30%) and morphological parameters like increased LV mass index (35%) were also observed.

Conclusions:

• CMR is a valid and reliable method for diagnosing "infarct-like myocarditis".
• Late gadolinium enhancement (LGE) is the most sensitive parameter for diagnosing this condition.
• Functional and morphological CMR parameters, alongside tissue characterization, enhance diagnostic capabilities for acute myocarditis.