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T1 mapping for characterization of myocardial fibrosis in hypertrophic cardiomyopathy
Journal of Cardiovascular Magnetic Resonance volume 18, Article number: P320 (2016)
It was reported that the occurrence of myocardial fibrosis was related to sudden cardiac death and heart failure in patients with HCM. Late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) is a widely used clinical method to detect fibrosis, however, its spatial resolution is limited. The purpose of this feasibility study is to determine the value of T1 mapping for the non-invasive assessment of myocardial fibrosis in patients with hypertrophic cardiomyopathy (HCM).
Thirty HCM patients and 20 healthy volunteers underwent conventional late gadolinium enhancement (LGE) imaging and T1 mapping (Siemens prototype sequence) on a clinical 1.5T scanner (MAGNETOM Aera, Siemens Healthcare). T1 mapping was performed with a modified look-locker inversion-recovery (MOLLI) sequence acquired during breath hold in the same planes after LGE imaging. Typical imaging parameters were: non-selective inversion pulse, steady-state free precession single-shot read out in mid-diastole, FOV of 360 × 250 mm2, matrix of 192 × 150, slice thickness of 8 mm, TR/TE of 375.28/1.01 ms, minimum inversion time of 90 ms, inversion time increment of 80 ms, FA of 35?, PAT factor of 2, number of inversions 2, images acquired after first inversion 3, pause 3 heart beats, and images acquired after second inversion. T1 Mapping was used for measurement of T1 values. Global ECV values were calculated from T1 maps acquired pre- and post-contrast calibrated by blood hematocrit. The extracellular volume (ECV) value was calculated as: ECV = (1-hematocrit) (1/T1myopost-1/T1myopre) / (1/T1bloodpost-1/T1bloodpre).
HCM patients had the same age as control group (38.2 ± 18.5 vs. 34.8 ± 15.7, P=NS). Pre-contrast myocardial T1 time and myocardial ECV in patients with HCM was significantly higher than the measurement in control cases, and post-contrast myocardial T1 time in HCM patients was significantly lower than that in control cases (P < 0.05, respectively) (Table 1, Figure 1).
The MOLLI T1 mapping used in the present study has combined the fast acquisition time and multiple contrast capabilities of the TI scout with the improved CNR, spatial resolution, and spatial coverage of the segmented IR LGE scans. The combination reduces the total imaging time, enables T1 quantification, and does not compromise image quality. A relatively higher pre-contrast T1 value and ECV, and lower post-contrast T1 value were found with T1 mapping in the myocardium of HCM patients, which suggested T1 mapping is better in the evaluation of myocardial fibrosis. The main limitation is that we had a small patient population without subgroup analysis and follow-up.
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Liu, Y., Qi, S., Wang, Z. et al. T1 mapping for characterization of myocardial fibrosis in hypertrophic cardiomyopathy. J Cardiovasc Magn Reson 18, P320 (2016). https://doi.org/10.1186/1532-429X-18-S1-P320
- Late Gadolinium Enhancement
- Hypertrophic Cardiomyopathy
- Myocardial Fibrosis
- Late Gadolinium Enhancement Imaging
- Compromise Image Quality