Diagnostic values of edema-sensitive T2-weighted imaging, TSE T1-weighted early contrast-enhanced imaging, late gadolinium enhancement, and the Lake Louise criteria in assessing acute myocarditis: A single-center cardiac magnetic resonance study
Objective: The aim of this study was to evaluate the diagnostic accuracy of the Lake Louise consensus criteria using cardiac magnetic resonance (CMR) imaging assessment of edema, hyperemia, and late gadolinium enhancement (LGE) in the diagnostic determination of acute myocarditis. Methods: A total o...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
KARE Publishing
2020-04-01
|
| Series: | Türk Kardiyoloji Derneği Arşivi |
| Subjects: | |
| Online Access: | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-67467 |
| _version_ | 1828029214427709440 |
|---|---|
| author | Deniz Alis Arda Güler Ozan Aşmakutlu Begüm Uygur Seyhan Ördekçi |
| author_facet | Deniz Alis Arda Güler Ozan Aşmakutlu Begüm Uygur Seyhan Ördekçi |
| author_sort | Deniz Alis |
| collection | DOAJ |
| description | Objective: The aim of this study was to evaluate the diagnostic accuracy of the Lake Louise consensus criteria using cardiac magnetic resonance (CMR) imaging assessment of edema, hyperemia, and late gadolinium enhancement (LGE) in the diagnostic determination of acute myocarditis.
Methods: A total of 44 patients with acute myocarditis and 24 healthy controls were included in this retrospective study. The presence of edema was defined as a myocardial mean signal intensity >1.9 times that of the skeletal muscle in the same slice on T2-weighted short tau inversion-recovery sequences. Hyperemia was defined as an early gadolinium enhancement ratio (EGEr) ≥4 calculated using the contrast-enhancement of the myocardium and skeletal muscle on TSE T1-weighted sequences, and LGE was assessed by visual examination. The reference methods used to determine the presence of myocarditis were based on the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases guidelines for clinical and biochemical findings.
Results: The diagnostic accuracy of edema, hyperemia, LGE, and the Lake Louise criteria (at least 2 of 3 components) was 75.7%, 64.2%, 88.5%, and 84.2%, respectively. Among the 3 components of the Lake Louise criteria, edema had the highest specificity (100%), and LGE had the highest sensitivity (86%). The use of LGE and/or edema as a criterion for acute myocarditis revealed the highest diagnostic accuracy (92.8%) among the CMR sequences and combinations of components examined.
Conclusion: LGE and/or edema as a sole criterion for the diagnosis of acute myocarditis demonstrated better diagnostic accuracy than the Lake Louise criteria. The use of EGEr did not improve the performance of CMR-based diagnosis. Alternatives to the use of EGEr are recommended for the diagnosis of acute myocarditis. |
| first_indexed | 2024-04-10T14:07:07Z |
| format | Article |
| id | doaj.art-ecf0e22b6bf84d6e9bf80f840a8bb5a1 |
| institution | Directory Open Access Journal |
| issn | 1016-5169 |
| language | English |
| last_indexed | 2024-04-10T14:07:07Z |
| publishDate | 2020-04-01 |
| publisher | KARE Publishing |
| record_format | Article |
| series | Türk Kardiyoloji Derneği Arşivi |
| spelling | doaj.art-ecf0e22b6bf84d6e9bf80f840a8bb5a12023-02-15T16:09:56ZengKARE PublishingTürk Kardiyoloji Derneği Arşivi1016-51692020-04-0148324625410.5543/tkda.2019.67467TKDA-67467Diagnostic values of edema-sensitive T2-weighted imaging, TSE T1-weighted early contrast-enhanced imaging, late gadolinium enhancement, and the Lake Louise criteria in assessing acute myocarditis: A single-center cardiac magnetic resonance studyDeniz Alis0Arda Güler1Ozan Aşmakutlu2Begüm Uygur3Seyhan Ördekçi4Department of Radiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, TurkeyDepartment of Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, TurkeyDepartment of Radiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, TurkeyDepartment of Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, TurkeyDepartment of Infectious Diseases, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, TurkeyObjective: The aim of this study was to evaluate the diagnostic accuracy of the Lake Louise consensus criteria using cardiac magnetic resonance (CMR) imaging assessment of edema, hyperemia, and late gadolinium enhancement (LGE) in the diagnostic determination of acute myocarditis. Methods: A total of 44 patients with acute myocarditis and 24 healthy controls were included in this retrospective study. The presence of edema was defined as a myocardial mean signal intensity >1.9 times that of the skeletal muscle in the same slice on T2-weighted short tau inversion-recovery sequences. Hyperemia was defined as an early gadolinium enhancement ratio (EGEr) ≥4 calculated using the contrast-enhancement of the myocardium and skeletal muscle on TSE T1-weighted sequences, and LGE was assessed by visual examination. The reference methods used to determine the presence of myocarditis were based on the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases guidelines for clinical and biochemical findings. Results: The diagnostic accuracy of edema, hyperemia, LGE, and the Lake Louise criteria (at least 2 of 3 components) was 75.7%, 64.2%, 88.5%, and 84.2%, respectively. Among the 3 components of the Lake Louise criteria, edema had the highest specificity (100%), and LGE had the highest sensitivity (86%). The use of LGE and/or edema as a criterion for acute myocarditis revealed the highest diagnostic accuracy (92.8%) among the CMR sequences and combinations of components examined. Conclusion: LGE and/or edema as a sole criterion for the diagnosis of acute myocarditis demonstrated better diagnostic accuracy than the Lake Louise criteria. The use of EGEr did not improve the performance of CMR-based diagnosis. Alternatives to the use of EGEr are recommended for the diagnosis of acute myocarditis.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-67467acute myocarditiscardiac magnetic resonance; edema; hyperemia; late gadolinium enhancement. |
| spellingShingle | Deniz Alis Arda Güler Ozan Aşmakutlu Begüm Uygur Seyhan Ördekçi Diagnostic values of edema-sensitive T2-weighted imaging, TSE T1-weighted early contrast-enhanced imaging, late gadolinium enhancement, and the Lake Louise criteria in assessing acute myocarditis: A single-center cardiac magnetic resonance study Türk Kardiyoloji Derneği Arşivi acute myocarditis cardiac magnetic resonance; edema; hyperemia; late gadolinium enhancement. |
| title | Diagnostic values of edema-sensitive T2-weighted imaging, TSE T1-weighted early contrast-enhanced imaging, late gadolinium enhancement, and the Lake Louise criteria in assessing acute myocarditis: A single-center cardiac magnetic resonance study |
| title_full | Diagnostic values of edema-sensitive T2-weighted imaging, TSE T1-weighted early contrast-enhanced imaging, late gadolinium enhancement, and the Lake Louise criteria in assessing acute myocarditis: A single-center cardiac magnetic resonance study |
| title_fullStr | Diagnostic values of edema-sensitive T2-weighted imaging, TSE T1-weighted early contrast-enhanced imaging, late gadolinium enhancement, and the Lake Louise criteria in assessing acute myocarditis: A single-center cardiac magnetic resonance study |
| title_full_unstemmed | Diagnostic values of edema-sensitive T2-weighted imaging, TSE T1-weighted early contrast-enhanced imaging, late gadolinium enhancement, and the Lake Louise criteria in assessing acute myocarditis: A single-center cardiac magnetic resonance study |
| title_short | Diagnostic values of edema-sensitive T2-weighted imaging, TSE T1-weighted early contrast-enhanced imaging, late gadolinium enhancement, and the Lake Louise criteria in assessing acute myocarditis: A single-center cardiac magnetic resonance study |
| title_sort | diagnostic values of edema sensitive t2 weighted imaging tse t1 weighted early contrast enhanced imaging late gadolinium enhancement and the lake louise criteria in assessing acute myocarditis a single center cardiac magnetic resonance study |
| topic | acute myocarditis cardiac magnetic resonance; edema; hyperemia; late gadolinium enhancement. |
| url | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-67467 |
| work_keys_str_mv | AT denizalis diagnosticvaluesofedemasensitivet2weightedimagingtset1weightedearlycontrastenhancedimaginglategadoliniumenhancementandthelakelouisecriteriainassessingacutemyocarditisasinglecentercardiacmagneticresonancestudy AT ardaguler diagnosticvaluesofedemasensitivet2weightedimagingtset1weightedearlycontrastenhancedimaginglategadoliniumenhancementandthelakelouisecriteriainassessingacutemyocarditisasinglecentercardiacmagneticresonancestudy AT ozanasmakutlu diagnosticvaluesofedemasensitivet2weightedimagingtset1weightedearlycontrastenhancedimaginglategadoliniumenhancementandthelakelouisecriteriainassessingacutemyocarditisasinglecentercardiacmagneticresonancestudy AT begumuygur diagnosticvaluesofedemasensitivet2weightedimagingtset1weightedearlycontrastenhancedimaginglategadoliniumenhancementandthelakelouisecriteriainassessingacutemyocarditisasinglecentercardiacmagneticresonancestudy AT seyhanordekci diagnosticvaluesofedemasensitivet2weightedimagingtset1weightedearlycontrastenhancedimaginglategadoliniumenhancementandthelakelouisecriteriainassessingacutemyocarditisasinglecentercardiacmagneticresonancestudy |