Diagnostic Accuracy of Mapping Techniques and Postprocessing Methods for Acute Myocarditis

Area of Science:

• Cardiovascular Magnetic Resonance Imaging
• Myocardial Pathology
• Quantitative Imaging

Background:

• Accurate diagnosis of acute myocarditis relies on appropriate T1 and T2 mapping sequences and measurement techniques.
• Various T1 and T2 mapping sequences and postprocessing methods exist, necessitating comparative studies for optimal application.

Purpose of the Study:

• To compare different T1 and T2 mapping sequences and measurement methods for diagnosing acute myocarditis.
• To evaluate the diagnostic performance of various cardiac MRI sequences in patients with acute myocarditis.

Main Methods:

• Retrospective evaluation of T1 mapping using four modified Look-Locker inversion recovery (MOLLI) sequences and T2 mapping using FLASH and true fast imaging with steady-state precession.
• Inclusion of 14 patients with acute myocarditis and 22 healthy controls, analyzing short-axis and segmental measurements.

Main Results:

• Significantly higher mean T1 and T2 values were observed in patients compared to controls across all sequences and most segments.
• The inferior and inferolateral segments demonstrated the highest area under the curve (AUC) values for T1 and T2 mapping.
• The MOLLI 3(2)3(2)5 sequence achieved the highest diagnostic performance with an AUC of 0.902 for short-axis measurements.

Conclusions:

• Native T1 and T2 mapping are effective in detecting pathological myocardial changes associated with acute myocarditis.
• Understanding the strengths and limitations of different cardiac MRI sequences enhances the accuracy of T1 and T2 mapping methods.