Key result
Multi-parameter 3.0 T cardiac MRI detected abnormalities in two of three parameters in 76% of children with suspected acute myocarditis and 54.1% with chronic myocarditis.
Why the study?
Comprehensive data for cardiac magnetic resonance based on the Lake Louise criteria in pediatric myocarditis were lacking.
Does multi-parameter 3.0 T cardiac MRI accurately diagnose acute and chronic myocarditis in pediatric patients?
Observational (n=90)
Does multi-parameter 3.0 T cardiac MRI accurately diagnose acute and chronic myocarditis in pediatric patients?
Comprehensive 3.0 T CMR is a powerful diagnostic tool for acute myocarditis in children, but its diagnostic value for chronic myocarditis is less satisfactory.
May support multi-parameter 3T CMR for suspected acute myocarditis in children; leaves chronic diagnostic performance open pending prospective studies.
Background Cardiac magnetic resonance (CMR) is an established tool for detection of myocarditis. However, no comprehensive data for CMR based on the “Lake Louise” criteria in pediatric myocarditis exists to date. Purpose To evaluate the value of multi-parameter CMR in children with suspected acute (AMC) and chronic myocarditis (CMC). Material and Methods We examined 73 pediatric patients with clinically suspected AMC (n = 25) and CMC (n = 48). We compared them to 17 controls. All individuals underwent CMR, including function analyses, T2 ratio, early gadolinium enhancement ratio (EGEr), and late gadolinium enhancement (LGE). Results In AMC, 19 (76%) patients were abnormal in any two of three parameters (T2 ratio, EGEr, and LGE). There was a significant difference between AMC and controls in LVEF (51.2% vs. 61.3%), mass (130.2 ± 14.0 vs. 120.5 ± 13.9 g), T2 ratio (1.96 ± 0.2 vs. 1.69 ± 0.13), and EGEr (4.1 ± 0.27 vs. 3.4 ± 0.39) ( P < 0.05). In CMC, 26 (54.1%) patients were abnormal in any two of three parameters. There was no significant difference between CMC and controls in LVEF and mass, but there was a statistical difference in T2 ratio (1.88 ± 0.18 vs. 1.69 ± 0.13) and in EGEr (3.93 ± 0.22 vs. 3.4 ± 0.39) ( P < 0.05). There was an increase in LVEF while both T2 ratio and EGEr significantly decreased ( P < 0.05) during follow-up of acute fulminant myocarditis. Conclusion Comprehensive CMR may serve as a powerful tool in children with suspected AMC. CMR in assessment of CMC may be valuable, but it is not satisfactory.
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Jia et al. (2020) conducted an observational in Suspected acute and chronic myocarditis (n=90). 3.0 T cardiac MRI vs. Controls was evaluated on Abnormalities in any two of three parameters (T2 ratio, EGEr, and LGE). Multi-parameter 3.0 T cardiac MRI detected abnormalities in two of three parameters in 76% of children with suspected acute myocarditis and 54.1% with chronic myocarditis.
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