Klinik für Strahlenheilkunde, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Eur Radiol. 2011 Jun;21(6):1259-66. doi: 10.1007/s00330-010-2022-1. Epub 2010 Nov 30.
To evaluate the role of MRI in diagnosing acute myocarditis by correlation with immunohistological parameters.
A total of 131 patients (85 men, 46 women; mean age, 44.9 years) with suspected acute myocarditis were examined by MRI. The relative water content of the left ventricular myocardium as well as relative and late enhancement was correlated with the immunohistological results in biopsy specimens.
Myocardial inflammation was confirmed by immunohistology in 82 of the 131 patients investigated and ruled out in 49 patients. The sensitivity, specificity and accuracy for diagnosing myocarditis in patients with immunohistologically proven disease were 48.8%, 73.8% and 57.3%, respectively, for relative enhancement, 58.3%, 57.1% and 57.9% for relative water content, and 30.6%, 88.1% and 49.6% for late enhancement. A combination of all three parameters had 39,3% sensitivity and 91,3% specificity and 62,7% accuracy. Relative enhancement and late enhancement significantly correlated with the presence of myocarditis but relative oedema did not.
Relative and late enhancement significantly correlate with the presence of myocarditis, while there is no significant correlation for relative oedema. Myocarditis cannot be reliably diagnosed using any of the three MRI parameters alone but combinations of parameters will improve specificity.
通过与免疫组织学参数相关联，评估 MRI 在诊断急性心肌炎中的作用。
对 131 例（85 例男性，46 例女性；平均年龄 44.9 岁）疑似急性心肌炎患者进行 MRI 检查。左心室心肌的相对含水量以及相对和延迟强化与活检标本的免疫组织学结果相关联。
在所研究的 131 例患者中，82 例经免疫组织学证实存在心肌炎症，49 例排除。在经免疫组织学证实患有心肌炎的患者中，相对强化的诊断敏感度、特异度和准确度分别为 48.8%、73.8%和 57.3%，相对含水量分别为 58.3%、57.1%和 57.9%，延迟强化分别为 30.6%、88.1%和 49.6%。三种参数的联合具有 39.3%的敏感度和 91.3%的特异度和 62.7%的准确度。相对强化和延迟强化与心肌炎的存在显著相关，但相对水肿没有。
相对和延迟强化与心肌炎的存在显著相关，而相对水肿则没有。仅使用三种 MRI 参数中的任何一种都不能可靠地诊断心肌炎，但参数的组合将提高特异性。
