Cardiovascular Magnetic Resonance in Nonischemic Myocardial Inflammation Expert Recommendations

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:72

Review

Ferreira, Vanessa M.¹  Schulz-Menger, Jeanette^2,3  Holmvang, Godtfred^4,5  Kramer, Christopher M.^6,7  Carbone, Iacopo⁸  Sechtem, Udo⁹  Kindermann, Ingrid¹⁰  Gutberlet, Matthias¹¹  Cooper, Leslie T.¹²  Liu, Peter¹³  Friedrich, Matthias G.^14,15,16 

[1] Univ Oxford, John Radcliffe Hosp, Ctr Clin Magnet Resonance Res, Oxford, England

[2] Charite, Dept Cardiol, Berlin, Germany

[3] HELIOS Klin, DZHK Partnersite Berlin, Berlin, Germany

[4] Massachusetts Gen Hosp, Div Cardiol, Boston, MA 02114 USA

[5] Massachusetts Gen Hosp, Dept Radiol, Boston, MA USA

[6] Univ Virginia Hlth Syst, Dept Med Cardiol, Charlottesville, VA USA

[7] Univ Virginia Hlth Syst, Dept Radiol, Charlottesville, VA USA

[8] Sapienza Univ Rome, Dept Radiol Oncol & Pathol Sci, Rome, Italy

[9] Robert Bosch Krankenhaus, Dept Cardiol, Stuttgart, Germany

[10] Saarland Univ, Med Ctr, Dept Internal Med 3, Homburg, Germany

[11] Univ Leipzig, Heart Ctr, Dept Diagnost & Intervent Radiol, Leipzig, Germany

[12] Mayo Clin, Dept Cardiol, Rochester, MN USA

[13] Ottawa Heart Inst, Ottawa, ON, Canada

[14] Heidelberg Univ Hosp, Heidelberg, Germany

[15] McGill Univ, Hlth Ctr, Dept Cardiol, Montreal, PQ, Canada

[16] McGill Univ, Hlth Ctr, Dept Diagnost Radiol, 1001 Decarie Blvd, Montreal, PQ H4A 3J1, Canada

关键词: cardiovascular magnetic resonance;    myocardial inflammation;    myocarditis;   

DOI  :  10.1016/j.jacc.2018.09.072

来源: Elsevier

【 摘 要 】

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. (c) 2018 Published by Elsevier on behalf of the American College of Cardiology Foundation.

【 授权许可】

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