Table 2.
Diagnostic performance of CMR tissue characterization methods in the detection of suspected acute myocarditis
| Tissue criteria | Sensitivity (%) | Specificity (%) | Accuracy (%) | PPV (%) | NPV (%) |
|---|---|---|---|---|---|
|
Individual |
|
|
|
|
|
| T1-mapping* |
90 |
88 |
89 |
90 |
88 |
| Dark-blood T2* |
48 |
86 |
66 |
81 |
58 |
| LGE |
72 |
97 |
81 |
98 |
67 |
|
Combination (with LGE) |
|
|
|
|
|
| Dark-blood T2 and LGE (2 out of 2)†‡ |
45 |
97 |
64 |
96 |
51 |
| Dark-blood T2 or LGE (Any 1 of 2) |
75 |
86 |
79 |
90 |
67 |
| T1-mapping and LGE (2 out of 2)† |
67 |
97 |
78 |
98 |
63 |
| T1-mapping or LGE (Any 1 of 2) |
95 |
83 |
91 |
91 |
91 |
| T1-mapping, dark-blood T2 or LGE (Any 1 of 3) |
95 |
71 |
86 |
85 |
89 |
| T1-mapping, dark-blood T2 or LGE (Any 2 of 3) |
70 |
97 |
80 |
98 |
65 |
| T1-mapping and dark-blood T2 and LGE (3 out of 3) |
45 |
97 |
64 |
96 |
51 |
|
Combination (without LGE) |
|
|
|
|
|
| T1-mapping and dark-blood T2 (2 out of 2)‡ |
48 |
98 |
71 |
97 |
61 |
| T1-mapping or dark-blood T2 (Any 1 of 2) | 90 | 76 | 84 | 82 | 86 |
*statistically different (p < 0.05); †‡no statistical difference (p = ns). T1-mapping: myocardial injury is detected when T1 is ≥ 990 ms; Dark-blood T2-weighted imaging: edema is diagnosed when the T2 SI ratio (T2 SI myocardium : skeletal muscle) is ≥ 2:1; Late gadolinium enhancement (LGE) is detected when myocardial SI is ≥ 2 SD above mean SI of remote myocardium. For each technique, only contiguous areas of myocardium ≥40 mm2 above the stated threshold were considered relevant; involvement of ≥5% of any segment on a per-subject basis was the threshold used for comparison of methods. PPV = positive predictive value; NPV = negative predictive value.