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The International Journal of Cardiovascular Imaging

, Volume 35, Issue 12, pp 2221–2229 | Cite as

Diagnostic and prognostic value of cardiac magnetic resonance in acute myocarditis: a systematic review and meta-analysis

  • Sarah Blissett
  • Yehuda Chocron
  • Bojan Kovacina
  • Jonathan AfilaloEmail author
Original Paper

Abstract

While diagnostic criteria were elaborated for acute myocarditis using cardiac magnetic resonance (CMR) in 2009, studies have since examined the yield of traditional and novel CMR parameters to achieve greater accuracy and to predict clinical outcomes. The purpose of this systematic review and meta-analysis was to determine the diagnostic and prognostic value of CMR parameters for acute myocarditis. MEDLINE and EMBASE were systematically searched for original studies that reported CMR parameters in adult patients suspected of acute myocarditis. Each CMR parameter's binary prevalence, mean value and standard deviation were extracted. Parameters were meta-analyzed using a random-effects model to generate standardized mean differences. After screening 1492 abstracts, 53 studies were included encompassing 2823 myocarditis patients and 803 controls. Pooled standardized mean differences between myocarditis patients and controls were: T2 mapping time 2.26 (95% CI 1.50–3.02), extracellular volume 1.64 (95% CI 0.87–2.42), LGE percentage 1.30 (95% CI 0.95–1.64), T1 mapping time 1.18 (95% CI 0.35–2.01), T2 ratio 1.17 (95% CI 0.80–1.54), and EGE ratio 0.93 (95% CI 0.66–1.19). Prolonged T1 mapping time had the highest sensitivity (82%), pericardial effusion had the highest specificity (99%). Baseline LV dysfunction and the presence of LGE were predictive of major adverse cardiac events. The results support integration of parametric mapping criteria in the diagnostic criteria for myocarditis. The presence of baseline LV dysfunction and LGE predict patients at higher risk of adverse events.

Keywords

Acute myocarditis Cardiac magnetic resonance Lake Louise criteria Parametric mapping Meta-analysis 

Notes

Acknowledgements

Sarah Blissett is grateful for support from the Western University Resident Research Career Development Funding.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10554_2019_1674_MOESM1_ESM.docx (1.4 mb)
Supplementary file1 (DOCX 1407 kb)

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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Sarah Blissett
    • 1
  • Yehuda Chocron
    • 2
  • Bojan Kovacina
    • 3
  • Jonathan Afilalo
    • 1
    • 2
    • 4
    Email author
  1. 1.Division of Cardiology, Azrieli Heart Centre, Jewish General HospitalMcGill UniversityMontrealCanada
  2. 2.Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General HospitalMcGill UniversityMontrealCanada
  3. 3.Department of Radiology, Jewish General HospitalMcGill UniversityMontrealCanada
  4. 4.McGill Integrated Cardiac Imaging Fellowship ProgramJewish General HospitalMontrealCanada

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