Practice Patterns of Cardiovascular Magnetic Resonance Use in the Diagnosis of Pediatric Myocarditis: A Survey-Based Study

Authors

Hannah M Jacobs
Jonathan H Soslow
Matthew D Cornicelli
Shae A Merves
Ruchira Garg
Mehul D Patel
Arpit Agarwal
Nilanjana Misra
Michael P DiLorenzo
M Jay Campbell
Jeremy Steele
Jennifer Co-Vu
Joshua D Robinson
Simon Lee
Jason N Johnson

Language

English

Publication Date

1-1-2024

Journal

Journal of Cardiovascular Magnetic Resonance

DOI

10.1016/j.jocmr.2024.101091

PMID

39270799

PMCID

PMC11647491

PubMedCentral® Posted Date

9-11-2024

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Cardiovascular magnetic resonance (CMR) is used to diagnose myocarditis in adults and children based on the original Lake Louise criteria (LLC) and more recently the revised LLC. The major change included in the revised LLC was the incorporation of parametric mapping, which significantly increases the sensitivity and specificity of diagnosis. Subsequently, scientific statements have recommended the use of parametric mapping in the diagnosis of myocarditis in children. However, there are some challenges to parametric mapping that are unique to the pediatric population. Our goal is to characterize clinical CMR and parametric mapping practice patterns for the diagnosis of myocarditis in pediatric centers.

Methods: The Cardiovascular Magnetic Resonance Evaluation in Return to Athletes for Myocarditis in Coronavirus Disease 2019 and Immunization Consortium (CERAMICi) created a Research Electronic Data Capture (REDCap) survey to evaluate clinical practice patterns for diagnosis of myocarditis in pediatrics. This survey was distributed to the Society for Cardiovascular Magnetic Resonance community.

Results: Fifty-nine responses from 51 centers were received, with only one response from each center being utilized. Only 35% (18/51) of centers (37% (14/38) North America, 31% (4/13) international) reported using CMR routinely in all patients with a suspicion of myocarditis. Diagnostic uncertainty was noted as the most important reason for CMR, while cost was noted as the least important consideration. The majority of centers reported using the revised LLC (37/51, 72%) compared to original LLC (7/51, 14%) or a hybrid criteria (6/51, 12%). When looking at the use of parametric mapping, only 5/47 (11%) for T1 mapping and 11/49 (22%) for T2 mapping reported having scanner-specific pediatric normative data.

Conclusion: Routine CMR imaging for diagnosis of myocarditis in pediatrics is infrequently performed at surveyed centers despite the focus on a group of non-invasive cardiac imagers. While the majority reported using parametric mapping, few centers reported having pediatric scanner-specific normative data. This highlights an important gap in the utilization of CMR that may aid in the diagnosis of myocardial disease.

Keywords

Adolescent, Child, Child, Preschool, Female, Humans, Male, Age Factors, COVID-19, Health Care Surveys, Magnetic Resonance Imaging, Myocarditis, Practice Patterns, Physicians', Predictive Value of Tests, Reproducibility of Results, Myocarditis, Lake Louise criteria, Parametric mapping, Pediatric

Published Open-Access

yes

Recommended Citation

Jacobs, Hannah M; Soslow, Jonathan H; Cornicelli, Matthew D; et al., "Practice Patterns of Cardiovascular Magnetic Resonance Use in the Diagnosis of Pediatric Myocarditis: A Survey-Based Study" (2024). Faculty, Staff and Student Publications. 5925.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/5925