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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Cardiovasc+Magn+Reson
2015 ; 17
(ä): 96
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Cardiovascular magnetic resonance techniques and findings in children with
myocarditis: a multicenter retrospective study
#MMPMID26576638
Banka P
; Robinson JD
; Uppu SC
; Harris MA
; Hasbani K
; Lai WW
; Richmond ME
; Fratz S
; Jain S
; Johnson TR
; Maskatia SA
; Lu JC
; Samyn MM
; Patton D
; Powell AJ
J Cardiovasc Magn Reson
2015[Nov]; 17
(ä): 96
PMID26576638
show ga
BACKGROUND: Cardiovascular magnetic resonance (CMR) is increasingly used to
diagnose myocarditis in adults but its use in children is not well-established.
We sought to describe the presentation, CMR protocol and findings, and outcomes
in a multicenter cohort of children with myocarditis. METHODS: Thirteen hospitals
retrospectively identified patients meeting the following inclusion criteria: 1)
diagnosis of myocarditis by the managing physicians, 2) age <21 years, 3) CMR
examination within 30 days of presentation, and 4) no congenital heart disease.
Clinical data and test results, including CMR findings, were abstracted from the
medical record. RESULTS: For the 143 patients meeting inclusion criteria, the
median age was 16.0 years (range, 0.1-20.3) and 139 (97 %) were hospitalized at
the time of CMR. The median time from presentation to CMR was 2 days (0-28). The
median left ventricular ejection fraction at CMR was 56 % (10-74), with 29 (20 %)
below 45 %. The median right ventricular ejection fraction was 54 % (15-72), with
11 (8 %) below 40 %. There was significant variability among centers in the types
of tissue characterization techniques employed (p?0.001). Overall, late
gadolinium enhancement (LGE) was used in 100 % of studies, followed by
T2-weighted imaging (T2W) in 69 %, first-pass contrast perfusion (FPP) in 48 %,
and early gadolinium enhancement (EGE) in 28 %. Abnormalities were most common
with LGE (81 %), followed by T2W (74 %), EGE (55 %), and FPP (8 %). The CMR study
was interpreted as positive for myocarditis in 117 patients (82 %), negative in
18 (13 %), and equivocal in 7 (5 %), yielding a sensitivity of 82 %. At a median
follow-up of 7.1 months (0-87), all patients were alive and 5 had undergone
cardiac transplantation. CMR parameters at presentation associated with
persistent left ventricular dysfunction were larger left ventricular
end-diastolic volume and lower left and right ventricular ejection fraction but
not abnormal LGE. CONCLUSIONS: Despite significant practice variation in imaging
protocol among centers, CMR had a high sensitivity for the diagnosis of
myocarditis in pediatric patients. Abnormalities were most often seen with LGE
followed by T2W, EGE, and FPP. These findings should be useful in designing
future prospective studies.