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- Open Access
T1-mapping accurately detects acute myocardial edema: a comparison to T2-weighted cardiovascular magnetic resonance imaging
© Ferreira et al; licensee BioMed Central Ltd. 2012
- Published: 1 February 2012
- Cardiovascular Magnetic Resonance
- Late Gadolinium Enhancement
- Takotsubo Cardiomyopathy
- Myocardial Stunning
- Myocardial Edema
Non-contrast T1-mapping using the novel ShMOLLI (Shortened Modified Look-Locker Inversion Recovery) sequence detects acute myocardial edema with high diagnostic accuracy.
T2-weighted cardiovascular magnetic resonance (CMR) is commonly used to detect myocardial edema. T1-mapping is also sensitive to changes in free water content and is quantitative, obviating the need for a presumed normal reference region to detect changes within affected myocardium. We hypothesized that T1-mapping using the novel sequence Shortened Modified Look-Locker Inversion Recovery (ShMOLLI) would have a higher diagnostic performance in detecting acute myocardial edema than dark-blood (STIR) and bright-blood (ACUT2E) T2-weighted CMR.
We investigated 18 healthy controls (age 53 ± 14 years) and 19 patients (age 61 ± 10 years) presenting with acute myocardial stunning without infarction. Stunning was defined as acute cardiac symptoms associated with positive biomarkers for injury and acute wall motion abnormalities, but without late gadolinium enhancement (LGE). CMR performed within 9 days included cine, ShMOLLI T1-mapping, STIR, ACUT2E and LGE imaging. We analyzed wall motion, absolute T1 values and T2 signal intensity (SI) relative to both skeletal muscle (T2 SI myo:skeletal) and remote myocardium (T2 SI myo:remote).
Non-contrast T1-mapping using ShMOLLI has a high diagnostic performance in detecting both focal and global myocardial edema compared to dark-blood and bright-blood T2-weighted CMR. T1-mapping may be used as a novel method to detect acute myocardial edema quantitatively, eliminating the need for subjective and presumed normal reference regions of interest.
This study is funded by the Oxford National Institute for Health Research Biomedical Research Centre Programme. VMF is funded by the Alberta Heritage Foundation for Medical Research (AHFMR) and the University of Oxford Clarendon Fund Scholarship. Dr. Robin Choudhury is a Wellcome Trust Senior Research Fellow in Clinical Science. Stefan Neubauer and Robin Choudhury acknowledge support from the British Heart Foundation Centre of Research Excellence, Oxford.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.