High inter- and intra-observer agreement in mapping sequences compared to classical Lake Louise Criteria assessment of myocarditis by inexperienced observers.
Clin Radiol
; 75(10): 796.e17-796.e26, 2020 10.
Article
in En
| MEDLINE
| ID: mdl-32698964
ABSTRACT
AIM:
To investigate the observer agreement for the assessment of chronic myocarditis by native T1 and T2 relaxation times, post-contrast T1 relaxation time, and extracellular volume (ECV) fraction, compared to Lake Louise Criteria oedema ratio (OR) and early gadolinium enhancement ratio (EGEr). MATERIALS ANDMETHODS:
Data were collected retrospectively on 71 consecutive patients who underwent cardiac magnetic resonance imaging as part of a complete diagnostic work-up according to current guidelines for suspected myocarditis. Thirteen cases were excluded due to previous myocardial infarction or technical issues. To test for intra- and interobserver agreement, the determination of the myocardial native T1 and T2 relaxation times, post-contrast T1 relaxation time, ECV, OR and EGEr was undertaken by two medical school graduates after comprehensive training. Bland-Altman analysis and intraclass correlation coefficient (ICC) were assessed.RESULTS:
The final analysis included 27 patients with chronic myocarditis, 21 patients with dilated cardiomyopathy and/or hypertensive heart disease, and 10 patients with unremarkable investigations in the control group. Excellent interobserver agreement was obtained for native T1 and T2 relaxation times, post-contrast T1 relaxation time and ECV, with ICC of 0.982/0.977/0.991/0.994, p < 0.001. Interobserver agreement was lower for OR and EGEr, with ICC of 0.841 and 0.818, p < 0.001, respectively. Mapping parameters (cut-off values T1 1,070 ms, T2 54 ms, ECV 30%) yield good performance in the diagnosis of chronic myocarditis with the best sensitivity/specificity/accuracy of 93%/80%/88% for ECV, followed by 70%/80%/74% for T2, and 52%/88%/69% for T1.CONCLUSIONS:
mapping parameters show excellent agreement between observers in the assessment of myocarditis.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Magnetic Resonance Imaging
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Clinical Competence
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Myocarditis
Type of study:
Diagnostic_studies
/
Guideline
/
Observational_studies
Limits:
Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Clin Radiol
Year:
2020
Type:
Article
Affiliation country:
United kingdom