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- Open Access
Early post-contrast T1 mapping yields maximal discriminatory capacity for detection of cardiac amyloid - influence of temporal T1 differences on MOLLI imaging
© Cooper et al.; licensee BioMed Central Ltd. 2014
- Published: 16 January 2014
- Cardiac Amyloid
- Myocardial Tissue Characterization
- Light Chain Type
- Sequential Time Point
- Contraction Fraction
Myocardial T1 mapping is increasingly used to diagnose and quantify disease burden in patients with known or suspected cardiac amyloid. Optimal timing for diagnostic application of T1 mapping is not established.
Myocardial T1 mapping was performed in two cohorts - (1) "amyloid +" subjects, defined by biopsy-proven systemic amyloid with associated remodeling suggestive of cardiac involvement (left ventricular [LV] hypertrophy and/or atrial dilation); (2) normative controls without risk factors for amyloid or cardiovascular disease. CMR (1.5T) included 2 components - cine-CMR (SSFP) for cardiac structure/function, and T1 mapping for myocardial tissue characterization. T1 mapping was performed using a conventional modified look locker inversion recovery (MOLLI) sequence (flip angle = 30°; matrix 256 × 128; parallel imaging reduction factor =1.5; linear view ordering; 6 Kaiser-Bessel ramp preparation; 17 heart beat acquisition), with T1 calculated using an established formula (T1 = T1* (B/A-1), T1*, A, and B obtained via three-parameter exponential fit). To test time dependent differences in myocardial T1, MOLLI was acquired at sequential time points (3,5,10,14, 20 minutes) following intravenous administration of gadolinium (0.2 mmol/kg).
MOLLI-quantified myocardial T1 yields maximal difference between amyloid-affected subjects and normative controls within 3 minutes following gadolinium administration. Increased magnitude of T1 difference early post contrast may relate to altered gadolinium contrast kinetics due to amyloid-associated increases in cardiac extracellular volume, and/or pulse-sequence aspects of the MOLLI approach. Current findings support use of early post-contrast MOLLI T1 mapping for identification of cardiac amyloid.
M. Cooper was supported by NSF GFRP DGE-0707428. J. Weinsaft was supported by NIH K23HL102249-01.
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