Comparison of original and 2018 Lake Louise criteria for diagnosis of acute myocarditis: results of a validation cohort
Radiology: Cardiothoracic Imaging, 2019•pubs.rsna.org
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 …
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 …
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.
Keywords: Adults, Cardiac, Cardiomyopathies, Heart, Left Ventricle, MR-Imaging
© RSNA, 2019
See also the commentary by Gutberlet and Lücke in this issue.
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