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27.06.2017 | Cardiac

Re-evaluation of a novel approach for quantitative myocardial oedema detection by analysing tissue inhomogeneity in acute myocarditis using T2-mapping

verfasst von: Bettina Baeßler, Frank Schaarschmidt, Melanie Treutlein, Christian Stehning, Bernhard Schnackenburg, Guido Michels, David Maintz, Alexander C. Bunck

Erschienen in: European Radiology | Ausgabe 12/2017

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Abstract

Objectives

To re-evaluate a recently suggested approach of quantifying myocardial oedema and increased tissue inhomogeneity in myocarditis by T2-mapping.

Methods

Cardiac magnetic resonance data of 99 patients with myocarditis were retrospectively analysed. Thirthy healthy volunteers served as controls. T2-mapping data were acquired at 1.5 T using a gradient-spin-echo T2-mapping sequence. T2-maps were segmented according to the 16-segments AHA-model. Segmental T2-values, segmental pixel-standard deviation (SD) and the derived parameters maxT2, maxSD and madSD were analysed and compared to the established Lake Louise criteria (LLC).

Results

A re-estimation of logistic regression models revealed that all models containing an SD-parameter were superior to any model containing global myocardial T2. Using a combined cut-off of 1.8 ms for madSD + 68 ms for maxT2 resulted in a diagnostic sensitivity of 75% and specificity of 80% and showed a similar diagnostic performance compared to LLC in receiver-operating-curve analyses. Combining madSD, maxT2 and late gadolinium enhancement (LGE) in a model resulted in a superior diagnostic performance compared to LLC (sensitivity 93%, specificity 83%).

Conclusions

The results show that the novel T2-mapping-derived parameters exhibit an additional diagnostic value over LGE with the inherent potential to overcome the current limitations of T2-mapping.

Key Points

• A novel quantitative approach to myocardial oedema imaging in myocarditis was re-evaluated.

• The T2-mapping-derived parameters maxT2 and madSD were compared to traditional Lake-Louise criteria.

• Using maxT2 and madSD with dedicated cut-offs performs similarly to Lake-Louise criteria.

• Adding maxT2 and madSD to LGE results in further increased diagnostic performance.

• This novel approach has the potential to overcome the limitations of T2-mapping.

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Titel: Re-evaluation of a novel approach for quantitative myocardial oedema detection by analysing tissue inhomogeneity in acute myocarditis using T2-mapping
verfasst von: Bettina Baeßler
Frank Schaarschmidt
Melanie Treutlein
Christian Stehning
Bernhard Schnackenburg
Guido Michels
David Maintz
Alexander C. Bunck
Publikationsdatum: 27.06.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 12/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-4894-9

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Re-evaluation of a novel approach for quantitative myocardial oedema detection by analysing tissue inhomogeneity in acute myocarditis using T2-mapping

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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Objectives

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Results

Conclusions

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