Quantitative Assessment of Late Gadolinium Enhancement and Edema at Cardiac Magnetic Resonance in Low-Risk Myocarditis Patients

Monti CB, Secchi F, Alì M, Carbone FS, Bonomo L, Capra D, Mobini N, Di Leo G, Sardanelli F. Quantitative Assessment of Late Gadolinium Enhancement and Edema at Cardiac Magnetic Resonance in Low-Risk Myocarditis Patients. Tomography. 2022 Apr 1;8(2):974-984. doi: 10.3390/tomography8020078. PMID: 35448712; PMCID: PMC9028348. Abstract In this study, we aimed to quantify LGE and edema at short-tau inversion recovery sequences on cardiac magnetic resonance (CMR) in patients with myocarditis. We retrospectively evaluated CMR examinations performed during the acute phase and at follow-up. Forty-seven patients were eligible for retrospective LGE assessment, and, among them, twenty-five patients were eligible for edema evaluation. Both groups were paired with age- and sex-matched controls. The median left ventricle LGE was 6.4% (interquartile range 5.0-9.2%) at the acute phase, 4.4% (3.3-7.2%) at follow-up, and 4.3% (3.0-5.3%) in controls, the acute phase being higher than both follow-up and controls (<em>p &amp;lt;</em> 0.001 for both), while follow-up and controls did not differ (<em>p =</em> 0.139). An optimal threshold of 5.0% was obtained for LGE with 87% sensitivity and 48% specificity; the positive likelihood ratio (LR) was 1.67, and the negative LR was 0.27. Edema was 12.8% (9.4-18.1%) at the acute phase, 7.3% (5.5-8.8%) at follow-up, and 6.7% (5.6-8.6%) in controls, the acute phase being higher than both follow-up and controls (both <em>p &amp;lt;</em> 0.001), while follow-up and controls did not differ (<em>p =</em> 0.900). An optimal threshold of 9.5% was obtained for edema with a sensitivity of 76% and a specificity of 88%; the positive LR was 6.33, and the negative LR was 0.27. LGE and edema thresholds are useful in cases of suspected mild myocarditis.Monti CB、Secchi F、Alì M、Carbone FS、Bonomo L、Capra D、Mobini N、Di Leo G、Sardanelli F. 《低风险心肌炎患者心脏磁共振晚期钆增强与水肿的定量评估》. 断层成像（Tomography）. 2022年4月1日;8(2):974-984. DOI: 10.3390/tomography8020078. PMID: 35448712；PMCID: PMC9028348. 摘要：本研究旨在定量评估心肌炎患者心脏磁共振（Cardiac Magnetic Resonance, CMR）短tau反转恢复序列下的晚期钆增强（Late Gadolinium Enhancement, LGE）与水肿水平。本研究回顾性分析了急性期及随访阶段的心脏磁共振检查资料。共计47例患者符合晚期钆增强回顾性评估的纳入标准，其中25例符合水肿评估的纳入标准。两组研究对象均匹配了年龄、性别一致的健康对照。急性期左心室晚期钆增强中位数为6.4%（四分位距5.0%~9.2%），随访阶段为4.4%（3.3%~7.2%），对照组为4.3%（3.0%~5.3%）；急性期晚期钆增强水平显著高于随访阶段与对照组（两组比较均p<0.001），而随访阶段与对照组差异无统计学意义（p=0.139）。晚期钆增强的最优截断值为5.0%，对应敏感度为87%，特异度为48%；阳性似然比为1.67，阴性似然比为0.27。水肿水平在急性期为12.8%（9.4%~18.1%），随访阶段为7.3%（5.5%~8.8%），对照组为6.7%（5.6%~8.6%）；急性期水肿水平显著高于随访阶段与对照组（两组比较均p<0.001），而随访阶段与对照组差异无统计学意义（p=0.900）。水肿的最优截断值为9.5%，对应敏感度为76%，特异度为88%；阳性似然比为6.33，阴性似然比为0.27。晚期钆增强与水肿的截断值可辅助疑似轻度心肌炎的临床诊断。