Diagnostic Performance of Extracellular Volume, Native T1, and T2 Mapping Versus Lake Louise Criteria by Cardiac Magnetic Resonance for Detection of Acute Myocarditis: A Meta-Analysis.
Diagnostic Performance of Extracellular Volume, Native T1, and T2 Mapping Versus Lake Louise Criteria by Cardiac Magnetic Resonance for Detection of Acute Myocarditis: A Meta-Analysis.
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通过心脏磁共振检测急性心肌炎的细胞外体积，天然T1和T2映射与路易丝湖标准的诊断性能：一项荟萃分析。
DOI：
10.1161/circimaging.118.007598
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发表时间：
2018-07
期刊：
影响因子：
--
通讯作者：
Salerno M
中科院分区：
文献类型：
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作者：
Pan JA;Lee YJ;Salerno M
露易丝湖标准（LLC）建立于2009年，是诊断疑似心肌炎患者的推荐心脏磁共振（CMR）成像标准。随后，可以量化T1，T2和细胞外容积（ECV）的更新的参数成像技术已经开发出来，并可能在心肌炎的诊断中提供额外的实用程序。然而，其诊断准确性是否上级LLC仍不清楚。在这项荟萃分析中，我们比较了天然T1，T2，ECV和LLC在诊断急性心肌炎中的诊断性能。我们在PubMed中检索了已发表的关于LLC、天然T1、ECV和T2诊断标准用于诊断急性心肌炎的研究。纳入了17项研究，共有867名心肌炎患者和441名对照受试者。通过双变量分析评估所有诊断试验的合并敏感性、特异性和诊断优势比（DOR）。LLC的合并灵敏度为74%，特异性为86%，DOR为17.7。天然T1的灵敏度显著高于LLC（85% vs 74%，p = 0.025）。另外，当比较LLC与天然T1、T2或ECV时，灵敏度、特异性和DOR无显著差异。天然T1、T2和ECV标测提供了与LLC相当的诊断性能。虽然只有天然T1的灵敏度明显优于LLC，但与LLC相比，每种技术在评价和表征心肌炎方面都具有明显的优势。
The Lake Louise Criteria (LLC) was established in 2009 and is the recommended cardiac magnetic resonance (CMR) imaging criterion for diagnosing patients with suspected myocarditis. Subsequently, newer parametric imaging techniques which can quantify T1, T2, and the extracellular volume (ECV) have been developed and may provide additional utility in the diagnosis of myocarditis. However, whether their diagnostic accuracy is superior to LLC remains unclear. In this meta-analysis, we compared the diagnostic performance of native T1, T2, ECV to LLC in diagnosing acute myocarditis. We searched PubMed for published studies of LLC, native T1, ECV, and T2 diagnostic criteria used to diagnose acute myocarditis. Seventeen studies were included, with a total of 867 myocarditis patients and 441 control subjects. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of all diagnostic tests were assessed by bivariate analysis. LLC had a pooled sensitivity of 74%, specificity of 86% and DOR of 17.7. Native T1 had a significantly higher sensitivity than LLC (85% vs 74%, p = 0.025). Otherwise, there was no significant difference in sensitivity, specificity, and DOR when comparing LLC to native T1, T2, or ECV. Native T1, T2, and ECV mapping provide comparable diagnostic performance to LLC. Although only native T1 had significantly better sensitivity than LLC, each technique offers distinct advantages for evaluating and characterizing myocarditis as compared to the LLC.