Multiparametric cardiac magnetic resonance imaging in pediatric and adolescent patients with acute myocarditis.

Background: The diagnostic value of cardiac magnetic resonance imaging (MRI) employing the 2018 Lake Louise criteria in pediatric and adolescent patients with acute myocarditis is undefined.Objective: To evaluate the diagnostic value of the Lake Louise criteria in pediatric and adolescent patients w...

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Publicado en:Pediatric Radiology Vol. 51; no. 13; pp. 2470 - 2481
Autores principales: Isaak, Alexander, Bischoff, Leon M., Faron, Anton, Endler, Christoph, Mesropyan, Narine, Sprinkart, Alois M., Pieper, Claus C., Kuetting, Daniel, Dabir, Darius, Attenberger, Ulrike, Luetkens, Julian A.
Formato: research Journal Article
Publicado: Springer Nature Dec2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2021
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00247-021-05169-7
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          Isaak, Alexander
          Bischoff, Leon M.
          Faron, Anton
          Endler, Christoph
          Mesropyan, Narine
          Sprinkart, Alois M.
          Pieper, Claus C.
          Kuetting, Daniel
          Dabir, Darius
          Attenberger, Ulrike
          Luetkens, Julian A.
        affil: Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
      sug:
        subj:
          Myocardial Diseases
          Human
          Young Adult
          Elements
          Retrospective Design
          Child
          Adolescence
          Acute Disease
          Contrast Media
          Magnetic Resonance Imaging
          Adult
          Comparative Studies
          Multicenter Studies
          Evaluation Research
          Validation Studies
          Child: 6-12 years
          Adolescent: 13-18 years
          Adult: 19-44 years
      ab: Background: The diagnostic value of cardiac magnetic resonance imaging (MRI) employing the 2018 Lake Louise criteria in pediatric and adolescent patients with acute myocarditis is undefined.Objective: To evaluate the diagnostic value of the Lake Louise criteria in pediatric and adolescent patients with suspected acute myocarditis and to show the utility of cardiac MRI for follow-up in this patient cohort.Materials and Methods: Forty-three patients (age range: 8-21 years) with suspected acute myocarditis and 13 control patients who underwent cardiac MRI were retrospectively analyzed. T2-weighted and late gadolinium enhancement imaging were performed in all patients. T1 and T2 mapping were available in 26/43 patients (60%). The Lake Louise criteria were assessed. In 27/43 patients (63%), cardiac MRI follow-up was available. Receiver operating characteristic analysis, Pearson's correlation coefficient and paired Student's t-test were used for statistical analysis.Results: In the total cohort, the Lake Louise criteria achieved a sensitivity of 86% (95% confidence interval [CI]: 72-95%) and a specificity of 100% (95% CI: 79-100%) for the diagnosis of acute myocarditis. In the subgroup of patients with available mapping parameters, the diagnostic performance of the Lake Louise criteria was higher when mapping parameters were implemented into the score (area under the receiver operating characteristic curve: 0.944 vs. 0.870; P=0.033). T2 relaxation times were higher in patients with admission to the intermediate care unit and were associated with the length of intermediate care unit stay (r=0.879, P=0.049). Cardiac MRI markers of active inflammation decreased on follow-up examinations (e.g., T1 relaxation times: 1,032±39 ms vs. 975±33 ms, P<0.001; T2 relaxation times: 58±5 ms vs. 54±5 ms, P=0.003).Conclusion: The Lake Louise criteria have a high diagnostic performance for the diagnosis of acute myocarditis and are a valuable tool for follow-up in pediatric and adolescent patients. The mapping techniques enhance the diagnostic performance of the 2018 Lake Louise criteria.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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