086 THE DETECTION OF ACUTE MYOCARDITIS USING CARDIOVASCULAR MRI: A CLINICAL STUDY COMPARING T1-MAPPING, T2-WEIGHTED AND LATE GADOLINIUM ENHANCEMENT IMAGING
Bibliographic record
Abstract
Background The accurate diagnosis of acute myocarditis on cardiovascular MRI (CMR) often requires multiple modalities, including T2-weighted (T2W), early and late gadolinium imaging. Novel CMR techniques are now available, including bright-blood T2W-CMR, and T1-mapping which is also sensitive to changes in free water content. We hypothesised that these emerging methods can serve as new and potentially superior diagnostic criteria for myocarditis. Methods We studied 45 healthy controls and 34 patients with suspected acute myocarditis. All patients presented with acute chest pain, troponin I >0.04 µg/l and had unobstructed coronary arteries on angiogram or ruled out clinically (eg, young age <35 years). CMR at 1.5 T within 12 days of presentation included (1) dark-blood T2 (STIR); (2) bright-blood T2 (ACUT2E); (3) T1-mapping (ShMOLLI); and (4) late gadolinium enhancement (LGE) (figure 1). Image analysis was performed for (1) global myocardial T2 signal intensity (SI) ratio against skeletal muscle; (2) mean myocardial T1 relaxation times; (3) LGE. Figure 1 Results All patients had a CMR diagnosis of acute myocarditis based on both positive T2-STIR and typical LGE pattern. Patients with an obvious alternate diagnosis (such as Takotsubo cardiomyopathy, hypertrophic cardiomyopathy) were excluded. Compared to controls, patients had significantly higher global myocardial T2 SI ratios by dark-blood T2W-CMR (1.81±0.28 vs 1.58±0.16, p<0.001), bright-blood T2W-CMR (2.90±0.33 vs 1.82±0.19, p<0.001) and mean myocardial T1 (1027±62 ms vs 942±21 ms, p<0.001). Receiver operator characteristic analysis showed good diagnostic performance for all methods, with T1-mapping having a significantly larger area-under-the-curve (0.95) compared to dark-blood T2W (0.79) and bright-blood T2W imaging (0.76; p<0.001 for both comparisons; figure 2). Figure 2 Conclusions T1-mapping showed superior diagnostic performance compared to conventional dark-blood and newer bright-blood T2W-CMR in the detection of acute myocarditis. T1-mapping and bright-blood T2W-CMR may be used as novel diagnostic criteria for the assessment of acute myocarditis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".