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Evaluation of the accuracy of gadolinium-enhanced cardiovascular magnetic resonance in the diagnosis of cardiac sarcoidosis Smedema JP; Snoep G; van Kroonenburgh MP; van Geuns RJ; Dassen WR; Gorgels AP; Crijns HJJ Am Coll Cardiol 2005[May]; 45 (10): 1683-90OBJECTIVES: This study analyzed the accuracy of gadolinium-enhanced cardiovascular magnetic resonance (CMR) for the diagnosis of cardiac sarcoidosis (CS). BACKGROUND: The diagnosis of CS was made according to the guidelines of the Japanese Ministry of Health and Welfare (1993); CMR has not been incorporated into the guidelines, and the diagnostic accuracy of CMR for the diagnosis of CS has not yet been evaluated. METHODS: We performed an analysis of 12-lead electrocardiograms (ECGs), 24-h ambulatory ECGs, echocardiograms, thallium scintigrams, and gadolinium-enhanced CMR studies in 58 biopsy-proven pulmonary sarcoidosis patients assessed for CS. The diagnostic accuracy of CMR for CS was determined using modified Japanese guidelines as the gold standard. RESULTS: The diagnosis of CS was made in 12 of 58 patients (21%); CMR revealed late gadolinium enhancement (LGE), mostly involving basal and lateral segments (73%), in 19 patients. In 8 of the 19 patients, scintigraphy was normal, while patchy LGE was present. The sensitivity and specificity of CMR were 100% (95% confidence interval, 78% to 100%) and 78% (95% confidence interval, 64% to 89%), and the positive and negative predictive values were 55% and 100%, respectively, with an overall accuracy of 83%. CONCLUSIONS: In patients with sarcoidosis, CMR is a useful diagnostic tool to determine cardiac involvement. New diagnostic guidelines should include CMR.|*Image Enhancement[MESH]|*Image Processing, Computer-Assisted[MESH]|*Magnetic Resonance Imaging[MESH]|Adult[MESH]|Biopsy[MESH]|Cardiomyopathies/*diagnosis[MESH]|Contrast Media/administration & dosage[MESH]|Electrocardiography, Ambulatory[MESH]|Female[MESH]|Gadolinium DTPA[MESH]|Humans[MESH]|Lung/pathology[MESH]|Male[MESH]|Middle Aged[MESH]|Myocardium/pathology[MESH]|Practice Guidelines as Topic[MESH]|Sarcoidosis, Pulmonary/diagnosis[MESH]|Sarcoidosis/*diagnosis[MESH]|Sensitivity and Specificity[MESH] |
