- Poster presentation
- Open access
- Published:
The diagnostic performance of non-contrast T1-mapping in patients with acute myocarditis on cardiovascular magnetic resonance imaging
Journal of Cardiovascular Magnetic Resonance volume 14, Article number: P179 (2012)
Summary
Non-contrast T1-mapping using ShMOLLI can serve as a novel CMR diagnostic criterion in patients presenting with suspected acute myocarditis.
Background
The accurate diagnosis of acute myocarditis on cardiovascular magnetic resonance imaging (CMR) often requires multiple modalities, including T2-weighted (T2w), early and late gadolinium imaging. T1-mapping is an emerging technique which is also sensitive to acute changes in free water content. We hypothesized that non-contrast T1-mapping using the novel Shortened Modified Look-Locker Inversion Recovery (ShMOLLI) sequence can serve as a new diagnostic criterion for acute myocarditis.
Methods
We studied 23 patients with suspected acute myocarditis and 17 healthy controls. All patients presented with chest pain and troponin I > 0.04 ug/L. CMR within 7 days included (1) T2w short-TI inversion recovery (STIR);(2) ShMOLLI T1-mapping; and (3) phase-sensitive late gadolinium enhancement (LGE) (Fig 1). T2 signal intensity (SI) relative to skeletal muscle (T2 SI ratio) and absolute T1 values per-subject were analyzed.
Results
All patients had a CMR diagnosis of acute myocarditis based on both positive T2-STIR and typical LGE pattern. Compared to controls, both mean T1 and T2 SI ratio in patients were significantly higher (T1=1036±71ms vs. T1=938±19; T2 SI ratio=1.77±0.24 vs. 1.52±0.10, p<0.0002 for both). Receiver operator characteristics analysis showed excellent diagnostic performance for both methods: the area-under-the-curve for ShMOLLI T1-mapping=0.96 and STIR=0.93 (p=0.3, Fig 2). The equal sensitivity and specificity points were T1=87% (T1=958ms) and T2=83% (T2 SI ratio=1.63).
Conclusions
Non-contrast T1-mapping using ShMOLLI has a high diagnostic performance for acute myocarditis and may be used as a novel additional CMR diagnostic criterion.
Funding
This study is funded by the Oxford National Institute for Health Research Biomedical Research Centre Programme. VMF is funded by the Alberta Heritage Foundation for Medical Research (AHFMR) and the University of Oxford Clarendon Fund Scholarship. Dr. Robin Choudhury is a Wellcome Trust Senior Research Fellow in Clinical Science. Stefan Neubauer and Robin Choudhury acknowledge support from the British Heart Foundation Centre of Research Excellence, Oxford.
Author information
Authors and Affiliations
Rights and permissions
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
About this article
Cite this article
Ferreira, V., Piechnik, S.K., Dall'Armellina, E. et al. The diagnostic performance of non-contrast T1-mapping in patients with acute myocarditis on cardiovascular magnetic resonance imaging. J Cardiovasc Magn Reson 14 (Suppl 1), P179 (2012). https://doi.org/10.1186/1532-429X-14-S1-P179
Published:
DOI: https://doi.org/10.1186/1532-429X-14-S1-P179