The value of dual-energy computed tomography in the evaluation of myocarditis

Abstract

PURPOSE The inflammation of the heart muscle is referred to as acute myocarditis. Cardiac magnetic reso-nance imaging (CMR) has become the primary method for a non-invasive assessment of myocardial inflammation. However, there are several drawbacks of CMR. During the last decade, dual energy computed tomography (DECT) has been used in cardiac imaging. The current study aims to assess the efficacy and feasibility of DECT in acute myocarditis and compare the results to CMR. METHODS This prospective study included patients who had myocarditis but no coronary artery pathology. Two observers evaluated the patients for acute myocarditis using DECT and CMR. CMR was per-formed on 22 patients within 24 hours of DECT, which was administered within 12 hours following the onset of chest pain. Inter-observer agreement was tested with Cohen's Kappa coefficient, and Spearman's correlation was used to examine the possible correlations. A P value of <0.050 was ac-cepted as statistically significant. RESULTS The DECT and CMR agreement was significant for transmural diagnoses, excellent for subepicardial and intramyocardial diagnoses, and perfect for nodular and band-like patterns. CONCLUSION The findings of this study showed that the dark areas on the color-coded iodine map created with DECT were strongly correlated with CMR in acute cases of myocarditis. In addition, DECT is a ro-bust imaging method that can also be used in the diagnosis of acute myocarditis. Furthermore, it provides information about coronary arteries faster and more reliably than magnetic resonance imaging without any limitations.