TY - JOUR
T1 - Cardiovascular Magnetic Resonance in Nonischemic Myocardial Inflammation
T2 - Expert Recommendations
AU - Ferreira, Vanessa M.
AU - Schulz-Menger, Jeanette
AU - Holmvang, Godtfred
AU - Kramer, Christopher M.
AU - Carbone, Iacopo
AU - Sechtem, Udo
AU - Kindermann, Ingrid
AU - Gutberlet, Matthias
AU - Cooper, Leslie T.
AU - Liu, Peter
AU - Friedrich, Matthias G.
N1 - Publisher Copyright:
© 2018
PY - 2018/12/18
Y1 - 2018/12/18
N2 - 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.
AB - 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.
KW - cardiovascular magnetic resonance
KW - myocardial inflammation
KW - myocarditis
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U2 - 10.1016/j.jacc.2018.09.072
DO - 10.1016/j.jacc.2018.09.072
M3 - Review article
C2 - 30545455
AN - SCOPUS:85057371011
SN - 0735-1097
VL - 72
SP - 3158
EP - 3176
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 24
ER -