TY - JOUR
T1 - Cardiac MR imaging in constrictive pericarditis
T2 - multiparametric assessment in patients with surgically proven constriction
AU - Bolen, Michael A.
AU - Rajiah, Prabhakar
AU - Kusunose, Kenya
AU - Collier, Patrick
AU - Klein, Allan
AU - Popović, Zoran B.
AU - Flamm, Scott D.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - To assess the utility of cardiac magnetic resonance (MR) imaging in the diagnosis of constrictive pericarditis (CP). This study was approved by the institutional review board, with a waiver of informed consent. A total of 42 consecutive patients (mean age, 55 ± 16 years; 3 women, 39 men) with CP treated with pericardiectomy who had undergone cardiac MR before surgery were evaluated retrospectively. An additional 21 patients were evaluated as a control group; of these, 10 consecutive patients received cardiac MR for reasons other than suspected pericardial disease, and 11 consecutive patients had a history of pericarditis but no clinical suspicion of pericardial constriction. MR imaging parameters were analyzed independently and with a decision tree algorithm for usefulness in the prediction of CP. Catheterization data were also reviewed when available. A model combining pericardial thickness and relative interventricular septal (IVS) excursion provided the best overall performance in prediction of CP (C statistic, 0.98, 100 % sensitivity, 90 % specificity). Several individual parameters also showed strong predictive value in the assessment of constriction, including relative IVS excursion (sensitivity, 93 %; specificity, 95 %), pericardial thickness (sensitivity, 83 %; specificity, 100 %), qualitative assessment of pathologic coupling (sensitivity, 88 %; specificity, 100 %), diastolic IVS bounce (sensitivity, 90 %; specificity, 85 %), left ventricle area change (sensitivity, 86 %; specificity, 100 %), and eccentricity index (sensitivity, 86 %; specificity, 90 %; all P < 0.001). Strong agreement was observed between catheterization and surgical findings of constriction (97 %). Cardiac MR provides robust quantitative and qualitative analysis for the diagnosis of CP.
AB - To assess the utility of cardiac magnetic resonance (MR) imaging in the diagnosis of constrictive pericarditis (CP). This study was approved by the institutional review board, with a waiver of informed consent. A total of 42 consecutive patients (mean age, 55 ± 16 years; 3 women, 39 men) with CP treated with pericardiectomy who had undergone cardiac MR before surgery were evaluated retrospectively. An additional 21 patients were evaluated as a control group; of these, 10 consecutive patients received cardiac MR for reasons other than suspected pericardial disease, and 11 consecutive patients had a history of pericarditis but no clinical suspicion of pericardial constriction. MR imaging parameters were analyzed independently and with a decision tree algorithm for usefulness in the prediction of CP. Catheterization data were also reviewed when available. A model combining pericardial thickness and relative interventricular septal (IVS) excursion provided the best overall performance in prediction of CP (C statistic, 0.98, 100 % sensitivity, 90 % specificity). Several individual parameters also showed strong predictive value in the assessment of constriction, including relative IVS excursion (sensitivity, 93 %; specificity, 95 %), pericardial thickness (sensitivity, 83 %; specificity, 100 %), qualitative assessment of pathologic coupling (sensitivity, 88 %; specificity, 100 %), diastolic IVS bounce (sensitivity, 90 %; specificity, 85 %), left ventricle area change (sensitivity, 86 %; specificity, 100 %), and eccentricity index (sensitivity, 86 %; specificity, 90 %; all P < 0.001). Strong agreement was observed between catheterization and surgical findings of constriction (97 %). Cardiac MR provides robust quantitative and qualitative analysis for the diagnosis of CP.
KW - Constrictive pericarditis
KW - Magnetic resonance
KW - Pericardium
UR - http://www.scopus.com/inward/record.url?scp=84939935015&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84939935015&partnerID=8YFLogxK
U2 - 10.1007/s10554-015-0616-z
DO - 10.1007/s10554-015-0616-z
M3 - Article
C2 - 25672267
AN - SCOPUS:84939935015
SN - 1569-5794
VL - 31
SP - 859
EP - 866
JO - International Journal of Cardiovascular Imaging
JF - International Journal of Cardiovascular Imaging
IS - 4
ER -