Assessment of sub-clinical acute cellular rejection after heart transplantation: comparison of cardiac magnetic resonance imaging and endomyocardial biopsy.
Objective: Comparing the diagnostic value of multi-sequential cardiac magnetic resonance imaging (CMR) with endomyocardial biopsy (EMB) for sub-clinical cardiac allograft rejection.Methods: One hundred and forty-six examinations in 73 patients (mean age 53 ± 12 years, 58 men) were performed using a...
| Publicado en: | European Radiology Vol. 24; no. 10; pp. 2360 - 2372 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Oct2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109755070&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109755070 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Oct2014 vid: 24 iid: 10 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 109755070 NLM24895035 2012709895 10.1007/s00330-014-3246-2 NLM24895035 PMC4155184 109755070 ppf: 2360 ppct: 12 formats: fmt: @attributes: type: P tig: atl: Assessment of sub-clinical acute cellular rejection after heart transplantation: comparison of cardiac magnetic resonance imaging and endomyocardial biopsy. aug: au: Krieghoff, Christian Barten, Markus J Hildebrand, Lysann Grothoff, Matthias Lehmkuhl, Lukas Lücke, Christian Andres, Claudia Nitzsche, Stefan Riese, Franziska Strüber, Martin Mohr, Friedrich Wilhelm Gutberlet, Matthias affil: Department of Diagnostic and Interventional Radiology, University Leipzig - Heart Centre, Leipzig, Germany, christian.krieghoff@herzzentrum-leipzig.de. sug: subj: Biopsy Methods Graft Rejection Heart Transplantation Magnetic Resonance Imaging Methods Myocardium Pathology Acute Disease Allografts Female Prospective Studies Human Male Middle Age Predictive Value of Tests ROC Curve Retrospective Design Middle Aged: 45-64 years Female Male ab: Objective: Comparing the diagnostic value of multi-sequential cardiac magnetic resonance imaging (CMR) with endomyocardial biopsy (EMB) for sub-clinical cardiac allograft rejection.Methods: One hundred and forty-six examinations in 73 patients (mean age 53 ± 12 years, 58 men) were performed using a 1.5 Tesla system and compared to EMB. Examinations included a STIR (short tau inversion recovery) sequence for calculation of edema ratio (ER), a T1-weighted spin-echo sequence for assessment of global relative enhancement (gRE), and inversion-recovery sequences to visualize late gadolinium enhancement (LGE). Histological grade ≥1B was considered relevant rejection.Results: One hundred and twenty-seven (127/146 = 87 %) EMBs demonstrated no or mild signs of rejection (grades ≤1A) and 19/146 (13 %) a relevant rejection (grade ≥1B). Sensitivity, specificity, positive predictive, and negative predictive values were as follows: ER: 63 %, 78 %, 30 %, and 93 %; gRE: 63 %, 70 %, 24 %, and 93 %; LGE: 68 %, 36 %, 13 %, and 87 %; with the combination of ER and gRE with at least one out of two positive: 84 %, 57 %, 23 %, and 96 %. ROC analysis revealed an area under the curve of 0.724 for ER and 0.659 for gRE.Conclusion: CMR parameters for myocarditis are useful to detect sub-clinical acute cellular rejection after heart transplantation. Comparable results to myocarditis can be achieved with a combination of parameters.Key Points: • Magnetic resonance imaging is useful for the assessment of cardiac allograft rejection. • CMR has a high negative predictive value for exclusion of allograft rejection. • Diagnostic performance is not yet good enough to replace endomyocardial biopsy. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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