Table 2.
Early gadolinium enhancement
| Study | Field strength | Sequence | Validation | Myocarditis (n) | Control (n) | Acute versus chronic cardiac inflammation | Control group | Test result | Sensitivity (%) | Specificity (%) | Diagnostic accuracy (%) | PPV (%) | NPV (%) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Friedrich et al. Circulation [3, 42] | 1 T | T1w spin echo sequence | Clinical | 19 | 18 | Acute | Healthy Participants | gRE | 84 | 89 | 86 | 89 | 84 |
| Laissy et al. Chest [3, 21] | 1 T | T1w sequence with short TR/TE | Clinical | 20 | 7 | Acute | Healthy Participants | MSE cut off 45% | 85 | 100 | 89 | 100 | 70 |
| Abdel-Aty et al. J Am Col Cardiol [22] | 1.5 T | T1w spin echo sequence | Clinical | 25 | 23 | Acute | Healthy Participants | gRE cut off 4.0 | 80 | 68 | 75 | 74 | 75 |
| Gutberlet et al. Radiology [23] | 1.5 T | T1w fast spin echo sequence | EMB | 48 | 35 | Chronic | Other diagnoses | gRE cut off 4.0 | 63 | 86 | 73 | 86 | 63 |
| Röttgen et al. Eur Radiol [24] | 1.5 T | T1w fast spin echo sequence | EMB | 82 | 49 | Acute | No inflammation on EMB | gRE cut off 4.0 | 49 | 74 | 57 | 78 | 43 |
| Voigt et al. Eur Radiol [25] | 1.5 T | T1w spin echo sequence | EMB | 12 | 11 | Chronic | No inflammation on EMB | gRE cut off 4.0 | 58 | 64 | 61 | 64 | 58 |
| Lurz et al. JACC Cardiovasc Imaging [26]a | 1.5 T | T1w fast spin echo sequence | EMB | 53 | 17 | Acute | Other diagnoses | gRE cut off 4.0 | 76 | 53 | 70 | 83 | 41 |
| Lurz et al. JACC Cardiovasc Imaging [26]a | 1.5 T | T1w fast spin echo sequence | EMB | 30 | 32 | Chronic | Other diagnoses | gRE cut off 4.0 | 73 | 21 | 48 | 51 | 40 |
| Chu et al. Int J Cardiovasc I [27] | 1.5 T | T1w turbo spin echo sequence | Clinical | 35 | 10 | Acute | Healthy Participants | gRE cut off 4.0 | 63 | 90 | 69 | 96 | 41 |
| Sramko et al. Am J Cardiol [29] | 1.5 T | T1w turbo flash sequence | EMB | 15 | 27 | Chronic | Idiopathic DCM | MSE cut off 45% | 40 | 96 | 76 | 85 | 74 |
| Radunski et al. JACC Cardiovasc Imaging [31] | 1.5 T | T1w spin echo sequence | Clinical | 104 | 21 | Mostly Acute | Healthy Participants | MSE cut off 56% | 63 | 71 | 59 | 91 | 31 |
| Luetkens et al. Radiology [32] | 3 T | T1w fast spin echo sequence | Clinical | 24 | 42 | Acute | Healthy Participants | gRE cut off 4.0 | 83 | 42 | 60 | 53 | 77 |
| Schwab et al. Rofo [33] | 1.5 T | T1w fast spin echo sequence | Clinical | 43 | 35 | Acute | Healthy Participants | Qualitative assessment | 51 | 94 | 71 | 92 | 61 |
| Luetkens et al. Eur H J Cardiovasc im [35] | 1.5 T | T1w fast spin echo sequence | Clinical | 34 | 50 | Acute | Healthy Participants | gRE cut off 1.95 | 77 | 62 | 67 | 58 | 80 |
| Pooled data | 544 | 377 | 65 | 69 | 67 | 75 | 58 | ||||||
| Chronic inflammation only | 62 | 66 | 64 | 65 | 64 | ||||||||
| Acute inflammation only | 66 | 70 | 67 | 78 | 56 | ||||||||
| Healthy participants as control | 69 | 70 | 69 | 77 | 60 | ||||||||
| Other diagnoses as controls | 61 | 67 | 63 | 72 | 55 |
DCM dilated cardiomyopathy, EMB endomyocardial biopsy, gRE – global relative enhancement, MSE myocardial signal enhancement, NPV negative predictive value, PPV positive predictive value, TE echo time, TR repeat time, T1w T1 weighted
aOne study examining two groups of patients with acute and chronic cardiac inflammation