0083 : Hyperhemia on the first-pass MRI perfusion for the diagnosis of acute myocarditis

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• 作者：Samuel Zarka ; ^{sam.zarka@icloud.com" class="auth_mail" title="E-mail the corresponding author} ; Claire Bouleti ; Dimitri Arangalage ; Houzefa Chopra ; Guillaume Baudry ; Philippe-Gabriel Steg ; Alec Vahanian ; Jean-Pierre Laissy ; Phalla Ou
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：8
• 期：3
• 页码：253
• 全文大小：113 K

文摘

MRI is the current way for the diagnosis of acute myocarditis, based on the Lake Louise criteria (presence of at least two of the three following criteria: myocardial edema, hyperaemia and/or a late Gadolinium enhancement). The first-pass perfusion sequence, used for detecting myocardial ischemia, may also be used to highlight a myocardial hyperemia in acute myocarditis.

Purpose

The aim of our study was to assess subepicardial hyperemia, seen on the first pass perfusion sequence by MRI, as a new method for the diagnosis of acute myocarditis.

Method

47 patients (mean age = 42.4±15,6 years; 35 men) with acute myocarditis were included and compared to 16 healthy controls (without heart disease). The first-pass perfusion was evaluated by two blinded observers and compared to myocardial late Gadolinium enhancement, considered the reference method for the diagnosis of acute myocarditis, using both a qualitative (visual analysis) and a semi-quantitative method (ratio of the signals: infarction hyperaemia / healthy myocardium).

Results

24 (51.1%) patients with myocarditis exhibited detectable hyperemia. Qualitative analysis showed good inter-observer variability (kappa = 0.75). There was an increase of the signal intensity in the myocardium with hyperhemia as compared to the adjacent normal myocardium (myocarditis vs controls: 1.08±0.03 vs 0.95±0.05, p=0.03; myocarditis with hyperhemia vs myocarditis non hyperhemia: 1.22±0.04 vs 0.94 ±0.04, p<0.0001). The correlation between the first-pass perfusion and late Gadolinium enhancement was good (kappa = 0,70). Considering the late Gadolinium enhancement as gold standard, the calculated values of sensitivity and specificity were 85% and 94%, respectively.

Conclusion

Hyperhemia on the First-pass perfusion sequence, is a valuable and reproducible tool for the diagnosis of acute myocarditis.

The author hereby declares no conflict of interest