Abstract 19159: Performance of T1 Mapping Cardiac Magnetic Resonance Imaging as Compared to Biventricular Endomyocardial Biopsy in Patients With Suspected Myocarditis
Background: The diagnostic performance of cardiac magnetic resonance (CMR) imaging in suspected myocarditis is still limited. Recently, CMR T1 mapping has been suggested to yield excellent diagnostic accuracies in patients with suspected myocarditis as compared to healthy controls. However, the true diagnostic performance of T1 mapping when compared to endomyocardial biopsy (EMB) in patients with a variety of pathologies is till unknown and was therefore assessed in this study.
Methods and Results: Within the final analyses, 129 consecutive patients with suspected acute or chronic myocarditis were included. Patients had to fulfill indications for CMR imaging according to the JACC White consensus paper.
All patients underwent biventricular EMB, cardiac catheterization for exclusion of coronary artery disease, and MRI on a 1.5 Tesla tomography (Intera, CV, Philips Medical Systems, Best, the Netherlands).
The CMR protocol included standard Lake-Louise (LL) parameters as well as native and post contrast T1 mapping using a modified Look-Locker inversion recovery sequence. Patients were divided into 2 groups according to duration of symptoms: patients with acute symptoms ≤14 days and those with chronic symptoms >14 days.
The diagnostic performance of LL criteria, native T1 and extracellular volume fraction (ECV) is summarized in the table. In patients with acute symptoms, native T1 yielded best diagnostic performance (81%) followed by ECV (75%), whereas accuracy of LL was found to be inadequate (60%). In patients with chronic symptoms, neither imaging technique or criteria yielded sufficient diagnostic accuracies.
Conclusion: In patients with acute symptoms and suspected myocarditis, T1 mapping provides a useful tool for the confirming or rejecting the diagnosis of myocarditis and is superior to LL criteria. In contrast, native T1 and extracellular volume fraction demonstrated unsatisfying diagnostic accuracies in patients with chronic symptoms.
Author Disclosures: P. Lurz: None. C. Luecke: None. F. Foehrenbach: None. C. Frank: None. I. Eitel: None. M. Sandri: None. E. Boudriot: None. S. de Waha: None. K. Klingel: None. R. Kandolf: None. G. Schuler: None. H. Thiele: None. M. Gutberlet: None.
- © 2015 by American Heart Association, Inc.