Luetkens Julian A, Faron Anton, Isaak Alexander, Dabir Darius, Kuetting Daniel, Feisst Andreas, Schmeel Frederic C, Sprinkart Alois M, Thomas Daniel
Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany.
Radiol Cardiothorac Imaging. 2019 Jul 25;1(3):e190010. doi: 10.1148/ryct.2019190010. eCollection 2019 Aug.
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.
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.
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 ( = .031). No differences in specificity were observed between both scores ( = .999).
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.© RSNA, 2019See also the commentary by Gutberlet and Lücke in this issue.
比较原始的路易斯湖标准（LLC）和2018年LLC对急性心肌炎的诊断性能，并同时验证先前报道的参数映射技术的截断值。
共有40例急性心肌炎患者和26名对照参与者接受了心脏磁共振成像（MRI）检查。心脏MRI检查方案允许评估T2信号强度比值、早期钆增强比值、延迟钆增强、T1弛豫时间、细胞外容积分数和T2弛豫时间。对原始的和2018年的LLC进行评估，并采用McNemar检验计算敏感性和特异性之间的差异。
2018年LLC的敏感性为87.5%（95%置信区间[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的敏感性相比，2018年LLC的敏感性显著更高（P = 0.031）。两种评分的特异性未观察到差异（P = 0.999）。
多参数心脏MRI对临床怀疑患有急性心肌炎的患者具有较高的诊断价值。2018年LLC通过提高敏感性进一步改善了心脏MRI的诊断性能。应考虑将新的评分纳入常规诊断方案。©RSNA，2019另见本期Gutberlet和Lücke的评论。
