Non-invasive differentiation of idiopathic inflammatory myopathy with cardiac involvement from acute viral myocarditis using cardiovascular magnetic resonance imaging T1 and T2 mapping.

Huber, Adrian Thomas; Bravetti, Marine; Lamy, Jérôme; Bacoyannis, Tania; Roux, Charles; de Cesare, Alain; Rigolet, Aude; Benveniste, Olivier; Allenbach, Yves; Kerneis, Mathieu; Cluzel, Philippe; Kachenoura, Nadjia; Redheuil, Alban (2018). Non-invasive differentiation of idiopathic inflammatory myopathy with cardiac involvement from acute viral myocarditis using cardiovascular magnetic resonance imaging T1 and T2 mapping. Journal of cardiovascular magnetic resonance, 20(1), p. 11. Taylor & Francis 10.1186/s12968-018-0430-6

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BACKGROUND Idiopathic inflammatory myopathy (IIM) is a group of autoimmune diseases with systemic myositis which may involve the myocardium. Cardiac involvement in IIM, although often subclinical, may mimic clinical manifestations of acute viral myocarditis (AVM). Our aim was to investigate the usefulness of the combined analysis of cardiovascular magnetic resonance (CMR) T1 and T2 mapping parameters measured both in the myocardium and in the thoracic skeletal muscles to differentiate AVM from IIM cardiac involvement. METHODS Sixty subjects were included in this retrospective study (36 male, age 45 ± 16 years): twenty patients with AVM, twenty patients with IIM and cardiac involvement and twenty healthy controls. Study participants underwent CMR imaging with modified Look-Locker inversion-recovery (MOLLI) T1 mapping and 3-point balanced steady-state-free precession T2 mapping. Relaxation times were quantified after endocardial and epicardial delineation on basal and medial short-axis slices, as well as in different thoracic skeletal muscle groups present in the CMR field-of-view. ROC-Analysis was performed to assess the ability of mapping indices to discriminate the study groups. RESULTS Mapping parameters in the thoracic skeletal muscles were able to discriminate between AVM and IIM patients. Best skeletal muscle parameters to identify IIM from AVM patients were reduced post-contrast T1 and increased extracellular volume (ECV), resulting in an area under the ROC curve (AUC) of 0.95 for post-contrast T1 and 0.96 for ECV. Conversely, myocardial mapping parameters did not discriminate IIM from AVM patients but increased native T1 (AUC 0.89 for AVM; 0.84 for IIM) and increased T2 (AUC 0.82 for AVM; 0.88 for IIM) could differentiate both patient groups from healthy controls. CONCLUSION CMR myocardial mapping detects cardiac inflammation in AVM and IIM compared to normal myocardium in healthy controls but does not differentiate IIM from AVM. However, thoracic skeletal muscle mapping was able to accurately discern IIM from AVM.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Huber, Adrian Thomas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1097-6647

Publisher:

Taylor & Francis

Language:

English

Submitter:

Nicole Rösch

Date Deposited:

23 Apr 2018 09:03

Last Modified:

27 Oct 2019 00:32

Publisher DOI:

10.1186/s12968-018-0430-6

PubMed ID:

29429407

Uncontrolled Keywords:

CMR T1/T2 mapping Cardiac inflammation Extracellular volume Skeletal muscle Systemic myositis

BORIS DOI:

10.7892/boris.113304

URI:

https://boris.unibe.ch/id/eprint/113304

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