Diagnostic performance of cardiovascular magnetic resonance parametric mapping as per modified Lake Louise Criteria in acute myocarditis: an updated systematic review and meta-analysis.

Q2 Medicine

Journal of Cardiovascular Imaging Pub Date : 2025-06-03 DOI:10.1186/s44348-025-00048-3

Latika Giri, Roshan Singh, Ahmed Marey, Yupeng Li, Bharath Ambale Venkatesh, Jawdat Abdulla, Stefan Zimmerman, Muhammad Umair

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Abstract

Background: Cardiovascular magnetic resonance mapping parameters-native T1 mapping, T2 mapping, and extracellular volume (ECV)-are key for diagnosing acute myocarditis under the modified 2018 Lake Louise Criteria (mLLC). This systematic review and meta-analysis evaluated their diagnostic performance and established optimal thresholds for acute myocarditis.

Methods: We reviewed articles published in the past decade utilizing parametric mapping for myocarditis diagnosis. Data on sensitivity, specificity, and area under the curve (AUC) were extracted. Quality assessment was conducted using the QUADAS-2 tool by two independent reviewers.

Results: Eleven studies with 677 patients were included. Native T1 mapping showed sensitivity of 83%, specificity of 86%, diagnostic odds ratio (DOR) of 39, and an AUC of 0.91. T2 mapping had sensitivity of 81%, specificity of 86%, DOR of 25, and an AUC of 0.89. ECV demonstrated sensitivity of 71%, specificity of 81%, DOR of 13, and an AUC of 0.83. Mean control values were 1,039 ± 39.23 ms for native T1 mapping, 57 ± 5.18 ms for T2 mapping, and 31% ± 5.60% for ECV. Optimal thresholds were 1,021 ms for native T1 mapping, 52 ms for T2 mapping, and 28% for ECV based on receiver operating characteristic curves analysis based on 1.5-T scanner value. Native T1 mapping showed the highest diagnostic accuracy. Subgroup analysis found no significant sensitivity differences based on biopsy or clinical criteria.

Conclusions: Parametric mapping, particularly native T1, demonstrated strong diagnostic performance for acute myocarditis compared to T2 mapping and ECV within the modified 2018 Lake Louise Criteria framework. Incorporating these cardiovascular magnetic resonance parameters may improve diagnostic accuracy. Further research is recommended to refine these findings and optimize diagnostic strategies.

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根据修改的Lake Louise标准进行心血管磁共振参数定位诊断急性心肌炎：一项最新的系统综述和荟萃分析。

背景：根据修改后的2018年Lake Louise标准（mLLC），心血管磁共振制图参数——原生T1制图、T2制图和细胞外体积（ECV）是诊断急性心肌炎的关键。本系统综述和荟萃分析评估了它们的诊断性能，并建立了急性心肌炎的最佳阈值。方法：我们回顾了近十年来发表的利用参数映射诊断心肌炎的文章。提取敏感性、特异性和曲线下面积（AUC）数据。质量评估由两名独立评审员使用QUADAS-2工具进行。结果：纳入11项研究，677例患者。原生T1定位的敏感性为83%，特异性为86%，诊断优势比（DOR）为39，AUC为0.91。T2定位的敏感性为81%，特异性为86%，DOR为25，AUC为0.89。ECV的敏感性为71%，特异性为81%，DOR为13，AUC为0.83。原生T1组对照值为1039±39.23 ms， T2组对照值为57±5.18 ms， ECV组对照值为31%±5.60%。基于1.5 t扫描值的接受者工作特征曲线分析，最佳阈值为原生T1映射1021 ms， T2映射52 ms， ECV 28%。原生T1映射显示最高的诊断准确性。亚组分析未发现基于活检或临床标准的显著敏感性差异。结论：与修改后的2018年Lake Louise标准框架内的T2制图和ECV相比，参数化制图，特别是原生T1，对急性心肌炎的诊断效果更好。结合这些心血管磁共振参数可以提高诊断的准确性。建议进一步研究以完善这些发现并优化诊断策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiovascular Imaging Medicine-Cardiology and Cardiovascular Medicine

CiteScore

3.40

自引率

0.00%

发文量