Salim Aymeric Si-Mohamed1,2, Lauria Marie Restier3, Arthur Branchu2, Sara Boccalini1,2, Anaelle Congi3, Arthur Ziegler2, Danka Tomasevic4, Thomas Bochaton4, Loic Boussel1,2, Philippe Charles Douek1,2. 1. Department of INSA-Lyon, University of Lyon, University Claude-Bernard Lyon 1, UJM-Saint-Étienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621 Lyon, France. 2. Cardiovascular and Thoracic Radiology Department, Hospices Civils de Lyon, 69500 Lyon, France. 3. Rockfeller Faculty of Medicine, Lyon Est, University Claude-Bernard Lyon 1, 69003 Lyon, France. 4. Department of Cardiology, Louis Pradel Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500 Bron, France.
Abstract
BACKGROUND: Myocardial extracellular volume (ECV) is a marker of the myocarditis inflammation burden and can be used for acute myocarditis diagnosis. Dual-energy computed tomography (DECT) enables its quantification with high concordance with cardiac magnetic resonance (CMR). PURPOSE: To investigate the diagnostic performance of myocardial ECV quantified on a cardiac dual-layer DECT in a population of patients with suspected myocarditis, in comparison to CMR. METHODS: 78 patients were included in this retrospective monocenter study, 60 were diagnosed with acute myocarditis and 18 patients were considered as a control population, based on the 2009 Lake and Louise criteria. All subjects underwent a cardiac DECT in acute phase consisted in an arterial phase followed by a late iodine enhancement phase at 10 min after injection (1.2 mL/kg, iodinated contrast agent). ECV was calculated using the hematocrit level measured the day of DECT examinations. Non-parametric analyses have been used to test the differences between groups and the correlations between the variables. A ROC curve has been used to identify the optimal ECV cut-off discriminating value allowing the detection of acute myocarditis cases. A p value < 0.05 has been considered as significant. RESULTS: The mean ECV was significantly higher (p < 0.001) for the myocarditis group compared to the control (34.18 ± 0.43 vs. 30.04 ± 0.53%). A cut-off value of ECV = 31.60% (ROC AUC = 0.835, p < 0.001) allows to discriminate the myocarditis with a sensitivity of 80% and a specificity of 78% (positive predictive value = 92.3%, negative predictive value = 53.8% and accuracy = 79.5%). CONCLUSION: Myocardial ECV enabled by DECT allows to diagnose the acute myocarditis with a cut-off at 31.60% for a sensitivity of 80% and specificity of 78%.
BACKGROUND: Myocardial extracellular volume (ECV) is a marker of the myocarditis inflammation burden and can be used for acute myocarditis diagnosis. Dual-energy computed tomography (DECT) enables its quantification with high concordance with cardiac magnetic resonance (CMR). PURPOSE: To investigate the diagnostic performance of myocardial ECV quantified on a cardiac dual-layer DECT in a population of patients with suspected myocarditis, in comparison to CMR. METHODS: 78 patients were included in this retrospective monocenter study, 60 were diagnosed with acute myocarditis and 18 patients were considered as a control population, based on the 2009 Lake and Louise criteria. All subjects underwent a cardiac DECT in acute phase consisted in an arterial phase followed by a late iodine enhancement phase at 10 min after injection (1.2 mL/kg, iodinated contrast agent). ECV was calculated using the hematocrit level measured the day of DECT examinations. Non-parametric analyses have been used to test the differences between groups and the correlations between the variables. A ROC curve has been used to identify the optimal ECV cut-off discriminating value allowing the detection of acute myocarditis cases. A p value < 0.05 has been considered as significant. RESULTS: The mean ECV was significantly higher (p < 0.001) for the myocarditis group compared to the control (34.18 ± 0.43 vs. 30.04 ± 0.53%). A cut-off value of ECV = 31.60% (ROC AUC = 0.835, p < 0.001) allows to discriminate the myocarditis with a sensitivity of 80% and a specificity of 78% (positive predictive value = 92.3%, negative predictive value = 53.8% and accuracy = 79.5%). CONCLUSION: Myocardial ECV enabled by DECT allows to diagnose the acute myocarditis with a cut-off at 31.60% for a sensitivity of 80% and specificity of 78%.
Authors: Jan M Brendel; Karin Klingel; Jens Kübler; Karin A L Müller; Florian Hagen; Meinrad Gawaz; Konstantin Nikolaou; Simon Greulich; Patrick Krumm Journal: J Clin Med Date: 2022-08-30 Impact factor: 4.964
Authors: Serena Dell'Aversana; Raffaele Ascione; Marco De Giorgi; Davide Raffaele De Lucia; Renato Cuocolo; Marco Boccalatte; Gerolamo Sibilio; Giovanni Napolitano; Giuseppe Muscogiuri; Sandro Sironi; Giuseppe Di Costanzo; Enrico Cavaglià; Massimo Imbriaco; Andrea Ponsiglione Journal: J Imaging Date: 2022-09-01