- Poster presentation
- Open Access
Myocardial T2 mapping is better than T2W Turbo Spin Echo for the diagnosis of acute myocarditis at 3T CMR
© Fernandes et al; licensee BioMed Central Ltd. 2013
- Published: 30 January 2013
- High Diagnostic Accuracy
- Body Coil
- Turbo Spin Echo
- Good Threshold
- Acute Myocarditis
Myocardial edema is usually assessed by T2W Turbo Spin Echo (TSE), using either Triple Inversion Recovery (STIR) or Double Inversion Recovery (DIR) with spectral fat saturation. Both TSE sequences have important drawbacks, such as low SNR when using the body coil, dropout of the lateral wall signal and use of semi-quantitative analysis by computing the ratio of myocardial to skeletal muscle signal intensity. We aimed to test a newly developed SSFP-based bright blood sequence that uses surface coils and quantifies myocardial T2 times on a pixel-by-pixel basis (T2 mapping).
A total of 14 (36%) patients were clinically diagnosed as acute myocarditis. The relationship between TSE and T2 map was poor in both per segment and per patient analyses (R= 0.28 and 0.33, respectively). T2 map had higher diagnostic accuracy per patient than TSE, with an area under the ROC curve of 0.78 and 0.69, respectively, p<0.001 for the difference. Based on the ROC curve, the best threshold for T2 map was 52 msec with sensitivity of 79% and specificity of 68%. The best threshold for TSE ratio was 2,1 with sensitivity of 79% and specificity of 60%. Segment-based image quality was better in T2 map versus TSE, with the percentage of grades 0 or 1 (poor quality) of 4% and 20% respectively, p<0.001.
Edema determination by T2 mapping has higher diagnostic accuracy for identifying patients with acute myocarditis than the usually performed T2W TSE. T2 map has also better overall image quality.
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.