Native T1-mapping detects the location, extent and patterns of acute myocarditis without the need for gadolinium contrast agents

Table 2 Diagnostic performance of CMR tissue characterization methods in the detection of suspected acute myocarditis

Tissue criteria	Sensitivity (%)	Specificity (%)	Accuracy (%)	PPV (%)	NPV (%)
Individual
T1-mapping*	90	88	89	90	88
Dark-blood T2*	48	86	66	81	58
LGE	72	97	81	98	67
Combination (with LGE)
Dark-blood T2 and LGE (2 out of 2)^†‡	45	97	64	96	51
Dark-blood T2 or LGE (Any 1 of 2)	75	86	79	90	67
T1-mapping and LGE (2 out of 2)^†	67	97	78	98	63
T1-mapping or LGE (Any 1 of 2)	95	83	91	91	91
T1-mapping, dark-blood T2 or LGE (Any 1 of 3)	95	71	86	85	89
T1-mapping, dark-blood T2 or LGE (Any 2 of 3)	70	97	80	98	65
T1-mapping and dark-blood T2 and LGE (3 out of 3)	45	97	64	96	51
Combination (without LGE)
T1-mapping and dark-blood T2 (2 out of 2)^‡	48	98	71	97	61
T1-mapping or dark-blood T2 (Any 1 of 2)	90	76	84	82	86

*statistically different (p < 0.05); ^†‡no statistical difference (p = ns). T1-mapping: myocardial injury is detected when T1 is ≥ 990 ms; Dark-blood T2-weighted imaging: edema is diagnosed when the T2 SI ratio (T2 SI _{myocardium : skeletal muscle}) is ≥ 2:1; Late gadolinium enhancement (LGE) is detected when myocardial SI is ≥ 2 SD above mean SI of remote myocardium. For each technique, only contiguous areas of myocardium ≥40 mm² above the stated threshold were considered relevant; involvement of ≥5% of any segment on a per-subject basis was the threshold used for comparison of methods. PPV = positive predictive value; NPV = negative predictive value.

ISSN: 1532-429X