Imaging myocardial inflammation by CMR mapping: good getting better?

In this issue of the European Heart Journal: Cardiovascular Imaging , Luetkens et al. 1 publish data on the diagnostic performance of cardiovascular magnetic resonance (CMR) tissue markers, specifically myocardial magnetic relaxation times, in detecting acute myocarditis. In 34 patients with clinical evidence for acute myocarditis and 50 controls, the diagnostic accuracy was found to be excellent for both current CMR markers (‘Lake Louise criteria’2) and myocardial relaxation times T1 and T2 (including the extracellular volume fraction, derived from post-contrast T1). The Lake Louise criteria yielded a diagnostic accuracy of 92% [sensitivity 82%, specificity 98%, area under the curve (AUC) 0.90]. Diagnostic accuracies of 96% were also achieved by combining relaxation times with high-signal-intensity areas in late gadolinium enhancement (LGE) images. Albeit not sensitive itself, the addition of longitudinal strain to native T1 and T2 also showed …

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