Cardiovascular Magnetic Resonance in Nonischemic Myocardial Inflammation: Expert Recommendations

Vanessa M. Ferreira, Jeanette Schulz-Menger, Godtfred Holmvang, Christopher M. Kramer, Iacopo Carbone, Udo Sechtem, Ingrid Kindermann, Matthias Gutberlet, Leslie T. Cooper, Peter Liu, Matthias G. Friedrich

Research output: Contribution to journalReview article

145 Scopus citations

Abstract

This JACC Scientific Expert Panel provides consensus recommendations for an update of the cardiovascular magnetic resonance (CMR) diagnostic criteria for myocardial inflammation in patients with suspected acute or active myocardial inflammation (Lake Louise Criteria) that include options to use parametric mapping techniques. While each parameter may indicate myocardial inflammation, the authors propose that CMR provides strong evidence for myocardial inflammation, with increasing specificity, if the CMR scan demonstrates the combination of myocardial edema with other CMR markers of inflammatory myocardial injury. This is based on at least one T2-based criterion (global or regional increase of myocardial T2 relaxation time or an increased signal intensity in T2-weighted CMR images), with at least one T1-based criterion (increased myocardial T1, extracellular volume, or late gadolinium enhancement). While having both a positive T2-based marker and a T1-based marker will increase specificity for diagnosing acute myocardial inflammation, having only one (i.e., T2-based OR T1-based) marker may still support a diagnosis of acute myocardial inflammation in an appropriate clinical scenario, albeit with less specificity. The update is expected to improve the diagnostic accuracy of CMR further in detecting myocardial inflammation.

Original languageEnglish (US)
Pages (from-to)3158-3176
Number of pages19
JournalJournal of the American College of Cardiology
Volume72
Issue number24
DOIs
StatePublished - Dec 18 2018

Keywords

  • cardiovascular magnetic resonance
  • myocardial inflammation
  • myocarditis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Ferreira, V. M., Schulz-Menger, J., Holmvang, G., Kramer, C. M., Carbone, I., Sechtem, U., Kindermann, I., Gutberlet, M., Cooper, L. T., Liu, P., & Friedrich, M. G. (2018). Cardiovascular Magnetic Resonance in Nonischemic Myocardial Inflammation: Expert Recommendations. Journal of the American College of Cardiology, 72(24), 3158-3176. https://doi.org/10.1016/j.jacc.2018.09.072