[心脏磁共振成像对急性病毒性心肌炎患者的诊断价值]

[Diagnostic value of cardiac magnetic resonance in patients with acute viral myocarditis].

作者信息

Ouyang Haichun, Chen Haixiong, Hu Yunzhao, Wu Yanxian, Li Wensheng, Chen Yuying, Cen Yujian

机构信息

Department of Cardiology, First People's Hospital of Shunde, Foshan 528300, China.

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出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2014 Nov;42(11):927-31.

PMID:25620255

Abstract

OBJECTIVE

To assess the diagnostic value of cardiac magnetic resonance (CMR) in patients with acute viral myocarditis.

METHODS

Thirty patients with suspected acute viral myocarditis admitted in first people's hospital of Shunde from June 2011 to June 2013 were included in this prospective study. The diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of acute viral myocarditis were evaluated by clinical diagnosis. Diagnostic value among different scan methods and Lake Louise criteria were compared.

RESULTS

Acute viral myocarditis was diagnosed in 63.33% (19/30) patients.Values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy within the overall cohort were 57.89%, 72.73%, 78.57%, 50.00%, 63.33%, respectively by edema imaging (ER).Values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy within the overall cohort were 78.95%, 63.64%, 78.95%, 63.64%, 73.33%, respectively using global relative enhancement (gRE).Values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy within the overall cohort were 78.95%, 54.55%, 75.00%, 60.00%, 70.00%, respectively using late gadolinium enhancement (LGE) criteria.Values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy within the overall cohort were 84.21%, 81.82%, 88.89%, 75.00%, 83.33% using Lake Louise criteria. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy using Lake Louise criteria were significantly higher than using ER, gRE, LGE alone(all P < 0.05).Specificity was higher using ER than using gRE and LGE (both P < 0.05). The sensitivity, NPV, and diagnostic accuracy were significantly higher using gRE than using ER (all P < 0.05) and was similar as using LGE (all P > 0.05).

CONCLUSION

Cardiac magnetic resonance is an excellent imaging modality for the diagnosis of acute viral myocarditis.

摘要

目的

评估心脏磁共振成像（CMR）对急性病毒性心肌炎患者的诊断价值。

方法

纳入2011年6月至2013年6月在顺德区第一人民医院收治的30例疑似急性病毒性心肌炎患者进行这项前瞻性研究。通过临床诊断评估急性病毒性心肌炎的诊断敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）及准确性。比较不同扫描方法及Lake Louise标准的诊断价值。

结果

63.33%（19/30）的患者被诊断为急性病毒性心肌炎。水肿成像（ER）评估整个队列的敏感性、特异性、PPV、NPV及诊断准确性分别为57.89%、72.73%、78.57%、50.00%、63.33%。采用整体相对强化（gRE）时，整个队列的敏感性、特异性、PPV、NPV及诊断准确性分别为78.95%、63.64%、78.95%、63.64%、73.33%。采用延迟钆增强（LGE）标准时，整个队列的敏感性、特异性、PPV、NPV及诊断准确性分别为78.95%、54.55%、75.00%、60.00%、70.00%。采用Lake Louise标准时，整个队列的敏感性、特异性、PPV、NPV及诊断准确性分别为84.21%、81.82%、88.89%、75.00%、83.33%。采用Lake Louise标准的敏感性、特异性、PPV、NPV及诊断准确性显著高于单独使用ER、gRE、LGE（均P<0.05）。ER的特异性高于gRE和LGE（均P<0.05）。gRE的敏感性、NPV及诊断准确性显著高于ER（均P<0.05），且与LGE相似（均P>0.05）。