Abstract:

Objective To explore the correlation of T2 ratio and LGE range measured by 3.0T cardiac magnetic resonance(CMR) with myocardial injury and left ventricular structure in children with viral myocarditis(VMC) and their impact on prognosis.

Methods A total of 93 children with VMC were selected as the research subjects, and all underwent 3.0T CMR examination. According to the 6-month prognosis, they were divided into good prognosis group(n=68) and poor prognosis group(n=25). The general information, serum cardiac troponin T(cTnT), creatine kinase isoenzyme(CK-MB), left ventricular structure［inter ventricular septum thickness(IVST), end diastolic volume(EDV), end systolic volume(ESV)］, CMR examination parameters ［T2 ratio, late gadolinium enhancement(LGE) range］ were compared between two groups. The correlation between T2 ratio, LGE range and serum cTnT, CK-MB, left ventricular structure indicators, and factors affecting the prognosis of children with VMC were analyzed, and the prognostic value of T2 ratio and LGE range alone and in combination were evaluated.

Results The proportion of fulminant myocarditis, hypotension, tachyarrhythmia, and use of epinephrine, as well as serum cTnT, CK-MB levels, IVST, EDV, and ESV, T2 ratio and LGE range on admission in the poor prognosis group were greater than those in the good prognosis group(P＜0.05). Correlation analysis results showed that T2 ratio(r=0.780, 0.770, 0.528, 0.494, 0.605), and LGE range(r=0.674, 0.880, 0.636, 0.575, 0.676) were positively correlated with serum cTnT, CK-MB, IVST, EDV, and ESV(P＜0.05). Logistic regression analysis showed that fulminant myocarditis, hypotension, tachyarrhythmia, use of epinephrine, T2 ratio and LGE range were important factors influencing the prognosis of children with VMC(P＜0.05). AUC value of combined detection of T2 ratio and LGE range in prediction was higher than that of single prediction(P＜0.05).

Conclusion The 3.0T CMR technique can evaluate the left ventricular function of children with VMC by measuring the T2 ratio and LGE range, and is closely related to myocardial injury and left ventricular structure, thus providing a reasonable basis for clinical evaluation and prognosis prediction.

Key words: myocarditis, magnetic resonance imaging, prognosis