Cardiac MRI Texture Analysis of T1 and T2 Maps in Patients with Infarctlike Acute Myocarditis
Cardiac MRI Texture Analysis of T1 and T2 Maps in Patients with Infarctlike Acute Myocarditis
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DOI：
10.1148/radiol.2018180411
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发表时间：
2018-11-01
期刊：
影响因子：
19.7
通讯作者：
Lurz, Philipp
中科院分区：
文献类型：
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作者：
Baessler, Bettina;Luecke, Christian;Lurz, Philipp
目的：评估纹理分析应用于心脏MRI获得的T1和T2图的诊断潜力，以诊断急性梗死样心肌炎。材料和方法：这项前瞻性研究于2012年8月至2015年5月进行，包括39名参与者（总体平均年龄+/-标准差，34.7岁+/- 12.2 [范围，18-63岁];女性平均年龄，46.1岁+/- 10.8 [范围，24-63岁];男性平均年龄为29.8 ± 9.2岁[范围为18-56岁]），来自心肌炎磁共振成像（MyoRacer）试验，临床疑似急性心肌炎和梗死样表现。参与者接受了双心室肌内膜活检、心导管插入术和1.5 T心脏MRI，其中评估了天然T1和T2标测以及露易丝湖标准（LLC）。通过使用免费提供的软件包对T1和T2图进行纹理分析。逐步降维和纹理特征选择进行选择功能，使心肌炎的诊断，使用endomyoorrhiza活检作为参考standard.Results：endomyoorrhiza活检证实了急性心肌炎的诊断26例，而13名参与者没有急性炎症的迹象。平均T1和T2值以及LLC显示出较低的诊断性能，受试者工作曲线分析的曲线下面积如下：T1为0.65（95%置信区间[CI]：0.45，0.85），T2为0.67（95% CI：0.49，0.85），LLC为0.62（95% CI：0.42，0.79）。结合纹理特征T2游程长度不均匀性和灰度不均匀性导致更高的诊断性能，曲线下面积为0.88（95% CI：0.73，1.00）（P <0.001），敏感性和特异性分别为89% [95%CI：81%，93%]和92% [95%CI：77%，93%]。T2图像纹理分析对急性梗死样心肌炎的诊断具有较高的敏感性和特异性。(c)RSNA，2018
Purpose: To assess the diagnostic potential of texture analysis applied to T1 and T2 maps obtained with cardiac MRI for the diagnosis of acute infarctlike myocarditis.Materials and Methods: This prospective study from August 2012 to May 2015 included 39 participants (overall mean age +/- standard deviation, 34.7 years +/- 12.2 [range, 18-63 years]; mean age of women, 46.1 years +/- 10.8 [range, 24-63 years]; mean age of men, 29.8 years +/- 9.2 [range, 18-56 years]) from the Magnetic Resonance Imaging in Myocarditis (MyoRacer) trial with clinical suspicion of acute myocarditis and infarctlike presentation. Participants underwent biventricular endomyocardial biopsy, cardiac catheterization, and cardiac MRI at 1.5 T, in which native T1 and T2 mapping as well as Lake Louise criteria (LLC) were assessed. Texture analysis was applied on T1 and T2 maps by using a freely available software package. Stepwise dimension reduction and texture feature selection was performed for selecting features enabling the diagnosis of myocarditis by using endomyocardial biopsy as the reference standard.Results: Endomyocardial biopsy confirmed the diagnosis of acute myocarditis in 26 patients, whereas 13 participants had no signs of acute inflammation. Mean T1 and T2 values and LLC showed a low diagnostic performance, with area under the curve in receiver operating curve analyses as follows: 0.65 (95% confidence interval [CI]: 0.45, 0.85) for T1, 0.67 (95% CI: 0.49, 0.85) for T2, and 0.62 (95% CI: 0.42, 0.79) for LLC. Combining the texture features T2 run-length nonuniformity and gray-level nonuniformity resulted in higher diagnostic performance with an area under the curve of 0.88 (95% CI: 0.73, 1.00) (P < .001) and a sensitivity and specificity of 89% [95% CI: 81%, 93%] and 92% [95% CI: 77%, 93%], respectively.Conclusion: Texture analysis of T2 maps shows high sensitivity and specificity for the diagnosis of acute infarctlike myocarditis. (c) RSNA, 2018