Non-contrast enhanced diagnosis of acute myocarditis based on the 17-segment heart model using 2D-feature tracking magnetic resonance imaging

Ravesh, Mona Salehi; Eden, Matthias; Langguth, Patrick; Piesch, Tim-Christian; Lehmann, J; Lebenatus, Annett; Hauttemann, David; Graessner, Joachim; Frey, Norbert; Jansen, Olav; Both, Marcus

doi:10.1016/j.mri.2019.11.008

Cited by 9 publications

(8 citation statements)

References 27 publications

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“…Impairment of the myocardial strain was more severe in patients with LGE positive myocarditis. Ravesh et al [ 32 ] found that the segmental myocardial strain (longitudinal, radial, and circumferential) made it possible to differentiate patient groups with different EF values, and they also found that the circumferential deformation analysis was more sensitive for patients with inconspicuous EF values. However, there is limited data in the literature on the correlation between severity of myocardial injury and segmental myocardial strain parameters.…”

Section: Discussionmentioning

confidence: 99%

Cardiac magnetic resonance feature tracking myocardial strain analysis in suspected acute myocarditis: diagnostic value and association with severity of myocardial injury

Gao

et al. 2023

BMC Cardiovasc Disord

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Background Albeit that cardiac magnetic resonance feature tracking (CMR-FT) has enabled quantitative assessment of global myocardial strain in the diagnosis of suspected acute myocarditis, the cardiac segmental dysfunction remains understudied. The aim of the present study was using CMR-FT to assess the global and segmental dysfunction of the myocardium for diagnosis of suspected acute myocarditis. Methods Forty-seven patients with suspected acute myocarditis (divided into impaired and preserved left ventricular ejection fraction [LVEF] groups) and 39 healthy controls (HCs) were studied. A total of 752 segments were divided into three subgroups, including segments with non-involvement (SNi), segments with edema (SE), and segments with both edema and late gadolinium enhancement (SE+LGE). 272 healthy segments served as the control group (SHCs). Results Compared with HCs, patients with preserved LVEF showed impaired global circumferential strain (GCS) and global longitudinal strain (GLS). Segmental strain analysis showed that the peak radial strain (PRS), peak circumferential strain (PCS), and peak longitudinal strain (PLS) values significantly reduced in SE+LGE compared with SHCs, SNi, SE. PCS significantly reduced in SNi (-15.3 ± 5.8% vs. -20.3 ± 6.4%, p < 0.001) and SE (-15.2 ± 5.6% vs. -20.3 ± 6.4%, p < 0.001), compared with SHCs. The area under the curve (AUC) values of GLS (0.723) and GCS (0.710) were higher than that of global peak radial strain (0.657) in the diagnosis of acute myocarditis, but the difference was not statistically significant. Adding the Lake Louise Criteria to the model resulted in a further increase in diagnostic performance. Conclusions Global and segmental myocardial strain were impaired in patients with suspected acute myocarditis, even in the edema or relatively non-involved regions. CMR-FT may serve as an incremental tool for assessment of cardiac dysfunction and provide important additional imaging-evidence for distinguishing the different severity of myocardial injury in myocarditis.

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Section: Discussionmentioning

confidence: 99%

Cardiac magnetic resonance feature tracking myocardial strain analysis in suspected acute myocarditis: diagnostic value and association with severity of myocardial injury

Gao

et al. 2023

BMC Cardiovasc Disord

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“…between its alterations and adverse clinical events. 33,34,59 In acute myocarditis, the most altered layers are the subepicardial and the intramyocardial, so that the impairment is more in global CS than in longitudinal strain (LS). Moreover, global CS is more accurate than global LS in characterizing acute myocarditis affecting the RV.…”

Section: Future Imaging Directions: Myocardial Strainmentioning

confidence: 99%

“…The mapping sequences are altered and characterized by an increase in both T1 and T2 values, with more variable T1 values than the T2 ones, and with areas of LGE in the inferior-lateral, anterior-lateral, and inferior-septal segments, with a more frequent subepicardial and mid-layer distribution, localized at the basal and mid-LV wall. 59 Moreover, Maurus and colleagues observed that not all the patients with myocarditis due to COVID-19 infection showed positivity for the LLC, and in particular a minor amount of myocardial edema was detected with respect to myocarditis caused by other etiologies. 58…”

Section: Imaging Findingsmentioning

confidence: 99%

“…Among all the viruses potentially affecting the myocardial wall, the recent SARS-CoV-2 infection is worthy of mention 57. In some patients, Coronavirus 2019 disease (COVID-19) can involve the myocardium in terms of myocarditis (40.2% of COVID-19 patients in the study of Ojha and colleagues) 58. In this setting, the acquisition of T1 and T2 mapping and LGE sequences has a crucial role.…”

Section: Introductionmentioning

confidence: 99%

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Emerging Role of Cardiac Magnetic Resonance Imaging in Diagnosing Myocarditis

Caredda

Bassareo

Cau

et al. 2022

Journal of Thoracic Imaging

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Acute myocarditis is a disease affecting the myocardial tissue, which is caused by infections, rheumatic diseases, especially sarcoidosis, or certain therapies. Its diagnosis may be difficult, owing to its variable clinical presentation. In this setting, cardiac magnetic resonance plays a pivotal role in detecting myocardial inflammation through qualitative, semiquantitative, and quantitative parameters, in particular with the new quantitative techniques such as T1 and T2 mapping, combined or not with late gadolinium enhancement evaluation. This is in accordance with the revised Lake Louise criteria. In this review, the emerging role of the new cutting-edge cardiac magnetic resonance imaging techniques in diagnosing myocarditis is extensively presented.

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“…Impairment of the myocardial strain was more severe in patients with LGE positive myocarditis. Ravesh et al (31) found that the segmental myocardial strain (longitudinal, radial, and circumferential) made it possible to differentiate patient groups with different EF values, and they also found that the circumferential deformation analysis was more sensitive for patients with inconspicuous EF values. However, these studies did not make clear the relationship between segmental myocardial strain changes and myocardial injury.…”

Section: Severity Of Myocardial Injury and Segmental Myocardial Strai...mentioning

confidence: 99%

Cardiac Magnetic Resonance Feature Tracking Myocardial Strain Analysis in Suspected Acute Myocarditis: Diagnostic Value and Association with Severity of Myocardial Injury

Gao

et al. 2022

Preprint

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Background: Albeit that cardiac magnetic resonance feature tracking (CMR-FT) has enabled quantitative assessment of global myocardial strain in the diagnosis of suspected acute myocarditis, the cardiac segmental dysfunction remains understudied. The aim of the present study was using CMR-FT to assess the global and segmental dysfunction of the myocardium for diagnosis of suspected acute myocarditis.Methods: 47 patients with suspected acute myocarditis (divided into impaired and preserved left ventricular ejection fraction [LVEF] groups) and 39 healthy controls (HCs) were studied. A total of 752 segments were divided into three subgroups, including segments with non-involvement (SNi), segments with edema (SE), and segments with both edema and late gadolinium enhancement (SE+LGE). 272 healthy segments served as the control group (SHCs).Results: Compared with HCs, patients with preserved LVEF showed impaired global circumferential strain (GCS) and global longitudinal strain (GLS). Segmental strain analysis showed that the peak radial strain (PRS), peak circumferential strain (PCS), and peak longitudinal strain (PLS) values significantly reduced in SE+LGE compared with SHCs, SNi, SE. PCS significantly reduced in SNi (-15.3±5.8% vs. -20.3±6.4%, p<0.001) and SE (-15.2±5.6% vs. -20.3±6.4%, p<0.001), compared with SHCs. The area under the curve (AUC) values of GLS (0.723) and GCS (0.710) were higher than that of global peak radial strain (0.657) in the diagnosis of acute myocarditis. Model with updated Lake Louise Criteria could result in a further increase in diagnostic performance.Conclusions: Global and segmental myocardial strain were impaired in patients with suspected acute myocarditis, even in the edema or relatively non-involved regions. CMR-FT may serve as an incremental tool for assessment of cardiac dysfunction and provide important additional imaging-evidence for distinguishing the different severity of myocardial injury in myocarditis.

show abstract

Non-contrast enhanced diagnosis of acute myocarditis based on the 17-segment heart model using 2D-feature tracking magnetic resonance imaging

Cited by 9 publications

References 27 publications

Cardiac magnetic resonance feature tracking myocardial strain analysis in suspected acute myocarditis: diagnostic value and association with severity of myocardial injury

Cardiac magnetic resonance feature tracking myocardial strain analysis in suspected acute myocarditis: diagnostic value and association with severity of myocardial injury

Emerging Role of Cardiac Magnetic Resonance Imaging in Diagnosing Myocarditis

Cardiac Magnetic Resonance Feature Tracking Myocardial Strain Analysis in Suspected Acute Myocarditis: Diagnostic Value and Association with Severity of Myocardial Injury

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