- Poster presentation
- Open Access
Myocardial extracellular space volume in patients with systemic sarcoidosis: quantitative measurement using a T1 mapping technique
© Yang et al.; licensee BioMed Central Ltd. 2014
- Published: 16 January 2014
- Cardiac Involvement
- Systemic Sarcoidosis
- Sarcoid Patient
- Diffuse Interstitial Fibrosis
- Lymphocytic Myocarditis
Cardiac involvement is a major risk factor for sudden death in patients with systemic sarcoidosis. Pathologically, cardiac sarcoid lesions can be classified as early (mainly lymphocytic, similar to lymphocytic myocarditis), intermediate (active granulomatous), and late phase (primarily scar). These pathological processes can affect the myocardial extracellular space volume (ECV) in cardiac sarcoid. We hypothesize that quantitative measurement of ECV using a T1 mapping technique with CMR may yield new insights for the assessment of cardiac sarcoid.
Nine patients with confirmed sarcoidosis were examined on a 1.5T MR system. First, a short-axis SSFP stack of slices covering the ventricles were acquired, and then a pre-contrast modified Look-Locker sequence was performed with 8 time points in a mid-LV level from which a T1 map and average LV myocardium T1 was derived. Post-contrast LGE-CMRs using IR-FGRE and multi-contrast late-enhancement were performed 10-15 minutes after a double-dose intravenous bolus injection of Gd-DTPA. A repeated T1 mapping sequence with the same localization as pre-contrast T1 measurement was acquired around 20 minutes post-contrast. The average myocardial T1 measurements did not exclude regions corresponding to LGE positive foci. LV function, LGE determination and quantitative T1 calculation used commercial software CMR42. Myocardial ECV was calculated according to the formula of ECV = (1-haematocrit) × (ΔR1myocardium/ΔR1blood).
This pilot study demonstrated increased myocardial ECV in patients with cardiac sarcoid, which may represent the combination of diffuse interstitial fibrosis and replacement scar. Further study is warranted for the clinical utility of T1 mapping and determination of ECV in the management of patients with cardiac sarcoid.
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. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.