Comparison of Original and 2018 Lake Louise Criteria for Diagnosis of Acute Myocarditis: Results of a Validation Cohort
Comparison of Original and 2018 Lake Louise Criteria for Diagnosis of Acute Myocarditis: Results of a Validation Cohort
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DOI：
10.1148/ryct.2019190010
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发表时间：
2019-08-01
期刊：
影响因子：
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通讯作者：
Thomas, Daniel
中科院分区：
文献类型：
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作者：
Luetkens, Julian A.;Faron, Anton;Thomas, Daniel
目的：比较原始露易丝湖标准（LLC）和2018年LLC诊断急性心肌炎的诊断性能，同时验证先前报道的参数映射technology.Materials和方法的截止值：共40例急性心肌炎患者和26名对照参与者进行心脏MRI。心脏MRI方案允许评估T2信号强度比、早期钆增强比、晚期钆增强、T1弛豫时间、细胞外容积分数和T2弛豫时间。结果：2018年版LLC的敏感性为87.5%（95%CI：73.9%，94.5%），特异性为96.2%（95%CI：81.1%，99.3%）。原始LLC的敏感性为72.5%（95% CI：57.2%，83.9%），特异性为96.2%（95% CI：81.1%，99.3%）。与原始LLC的灵敏度相比，2018年LLC的灵敏度显着更高（P =.031）。两种评分之间的特异性无差异（P =.999）结论：多参数心脏MRI对临床疑似急性心肌炎患者的诊断具有较高的诊断价值。2018 LLC通过提高心脏MRI的灵敏度，进一步提高了其诊断性能。应考虑将新评分纳入常规诊断方案。
Purpose: To compare the diagnostic performance of the original Lake Louise criteria (LLC) and the 2018 LLC for the diagnosis of acute myocarditis and simultaneously validate previously reported cutoff values for parametric mapping techniques.Materials and Methods: A total of 40 patients with acute myocarditis and 26 control participants underwent cardiac MRI. Cardiac MRI protocol allowed for assessment of T2 signal intensity ratio, early gadolinium enhancement ratio, late gadolinium enhancement, T1 relaxation times, extracellular volume fraction, and T2 relaxation times. The original and the 2018 LLC were assessed, and differences between sensitivities and specificities were calculated with the McNemar test.Results: The 2018 LLC yielded a sensitivity of 87.5% (95% confidence interval [CI]: 73.9%, 94.5%) and a specificity of 96.2% (95% CI: 81.1%, 99.3%). The original LLC had a sensitivity of 72.5% (95% CI: 57.2%, 83.9%) and a specificity of 96.2% (95% CI: 81.1%, 99.3%). Sensitivity of the 2018 LLC was significantly higher compared with the sensitivity of original LLC (P =.031). No differences in specificity were observed between both scores (P =.999)Conclusion: Multiparametric cardiac MRI has a high diagnostic value for the diagnosis of patients clinically suspected of having acute myocarditis. The 2018 LLC further improve the diagnostic performance of cardiac MRI by increasing its sensitivity. An implementation of the new score into routine diagnostic protocols should be considered.