Myocardial Tissue Characterization by Combining Extracellular Volume Fraction and T2 Mapping

AbstractMapping the effective transverse relaxation time T2* represents an emerging MRI tool for non-invasive myocardial tissue characterization and holds the promise to provide means for assessing myocardial (patho)physiology in vivo. This work takes advantage of the linear increase of susceptibility effects with magnetic field strength which renders it appealing to perform T2* mapping at ultrahigh magnetic fields and enables temporally resolved T2* mapping. Recognizing this potential this study examines the applicability of myocardial CINE T2* mapping in healthy volunteers and hypertrophic cardiomyopathy (HCM) patients at 7.0 Tesla and investigates its capability to distinguish between healthy myocardium and myocardium affected by HCM.

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Quantification of Liver Fibrosis at T1 and T2 Mapping with Extracellular Volume Fraction MRI: Preclinical Results

Radiology ◽

10.1148/radiol.2018180051 ◽

2018 ◽

Vol 288 (3) ◽

pp. 748-754 ◽

Cited By ~ 28

Author(s):

Julian A. Luetkens ◽

Sabine Klein ◽

Frank Träber ◽

Frederic C. Schmeel ◽

Alois M. Sprinkart ◽

...

Keyword(s):

Liver Fibrosis ◽

Volume Fraction ◽

T2 Mapping ◽

Extracellular Volume ◽

Extracellular Volume Fraction ◽

T1 And T2

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T1, T2 Mapping and Extracellular Volume Fraction (ECV): Application, Value and Further Perspectives in Myocardial Inflammation and Cardiomyopathies

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren ◽

10.1055/s-0034-1399546 ◽

2015 ◽

Vol 187 (09) ◽

pp. 760-770 ◽

Cited By ~ 19

Author(s):

F. Roller ◽

S. Harth ◽

C. Schneider ◽

G. Krombach

Keyword(s):

Volume Fraction ◽

T2 Mapping ◽

Extracellular Volume ◽

Extracellular Volume Fraction ◽

Myocardial Inflammation

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The Double-Edged Sword of T1-Mapping in Systemic Sclerosis—A Comparison with Infectious Myocarditis Using Cardiovascular Magnetic Resonance

Diagnostics ◽

10.3390/diagnostics10050335 ◽

2020 ◽

Vol 10 (5) ◽

pp. 335

Author(s):

George Markousis-Mavrogenis ◽

Loukia Koutsogeorgopoulou ◽

Gikas Katsifis ◽

Theodoros Dimitroulas ◽

Genovefa Kolovou ◽

...

Keyword(s):

Systemic Sclerosis ◽

T1 Mapping ◽

Volume Fraction ◽

T2 Mapping ◽

Extracellular Volume ◽

Surrogate Marker ◽

Extracellular Volume Fraction ◽

Myocardial Inflammation ◽

Gadolinium Enhancement ◽

Signal Ratio

Aims: T1-mapping is considered a surrogate marker of acute myocardial inflammation. However, in diffuse cutaneous systemic sclerosis (dcSSc) this might be confounded by coexisting myocardial fibrosis. We hypothesized that T1-based indices should not by themselves be considered as indicators of myocardial inflammation in dcSSc patients. Methods/Results: A cohort of 59 dcSSc and 34 infectious myocarditis patients was prospectively evaluated using a 1.5-Tesla system for an indication of suspected myocardial inflammation and was compared with 31 healthy controls. Collectively, 33 (97%) and 57 (98%) of myocarditis and dcSSc patients respectively had ≥1 pathologic T2-based index. However, 33 (97%) and 45 (76%) of myocarditis and dcSSc patients respectively had ≥1 pathologic T2-based index. T2-signal ratio was significantly higher in myocarditis patients compared with dcSSc patients (2.5 (0.6) vs. 2.1 (0.4), p < 0.001). Early gadolinium enhancement, late gadolinium enhancement and T2-mapping did not differ significantly between groups. However, both native T1-mapping and extracellular volume fraction were significantly lower in myocarditis compared with dcSSc patients (1051.0 (1027.0, 1099.0) vs. 1120.0 (1065.0, 1170.0), p < 0.001 and 28.0 (26.0, 30.0) vs. 31.5 (30.0, 33.0), p < 0.001, respectively). The original Lake Louise criteria (LLc) were positive in 34 (100%) myocarditis and 40 (69%) dcSSc patients, while the updated LLc were positive in 32 (94%) and 44 (76%) patients, respectively. Both criteria had good agreement with greater but nonsignificant discordance in dcSSc patients. Conclusions: ~25% of dcSSc patients with suspected myocardial inflammation had no CMR evidence of acute inflammatory processes. T1-based indices should not be used by themselves as surrogates of acute myocardial inflammation in dcSSc patients.

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Prognostic Value of Myocardial Extracellular Volume Fraction and T2-mapping in Heart Transplant Patients

JACC Cardiovascular Imaging ◽

10.1016/j.jcmg.2020.01.014 ◽

2020 ◽

Vol 13 (7) ◽

pp. 1521-1530 ◽

Cited By ~ 4

Author(s):

Kongkiat Chaikriangkrai ◽

Muhannad Aboud Abbasi ◽

Roberto Sarnari ◽

Ryan Dolan ◽

Daniel Lee ◽

...

Keyword(s):

Heart Transplant ◽

Prognostic Value ◽

Volume Fraction ◽

T2 Mapping ◽

Extracellular Volume ◽

Extracellular Volume Fraction ◽

Transplant Patients

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Value CMR: Towards a Comprehensive, Rapid, Cost-Effective Cardiovascular Magnetic Resonance Imaging

10.1101/2020.10.09.20204305 ◽

2020 ◽

Author(s):

El-Sayed H. Ibrahim ◽

Luba Frank ◽

Dhiraj Baruah ◽

Jason C. Rubenstein ◽

V. Emre Arpinar ◽

...

Keyword(s):

Contrast Agent ◽

Tissue Characterization ◽

Heart Function ◽

T2 Mapping ◽

Cine Imaging ◽

Breath Hold ◽

Myocardial Tissue ◽

4D Flow ◽

Scan Time ◽

Myocardial Tissue Characterization

AbstractCMR is considered the gold standard for measuring heart function, including cardiac volumes and mass. Further, in a single CMR exam, information about cardiac function, structure, tissue composition, and blood flow could be obtained. Nevertheless, CMR is underutilized due to long scanning times, the need for multiple breath-holds, use of a contrast agent, and relatively higher cost compared to echocardiography.In this study, we propose a rapid CMR exam based on recent developments in imaging sequences. The proposed exam is both rapid and provides comprehensive cardiovascular information without the need for a contrast agent or multiple breath-holds. The developed exam includes advanced sequences for evaluating global and regional cardiac functions, myocardial tissue characterization, and flow hemodynamics in the heart, valves, and large vessels. Time-consuming conventional sequences have been replaced by advanced sequences, which resulted in reducing scan time from > 1 hour with conventional CMR exam to <20 minutes with the proposed rapid CMR exam. Specifically, conventional two-dimensional (2D) cine and phase-contrast (PC) sequences have been replaced by optimized three-dimensional (3D)-cine and four-dimensional (4D)-flow sequences, respectively. Compared to 2D cine imaging that requires 12-16 separate breath-holds, the implemented 3D-cine sequence allows for whole heart coverage in 1-2 breath-holds; thus, reducing scan time by 80-90%. Similarly, compared to 2D PC flow imaging that requires multiple breath-holds and the presence of an experienced cardiac operator for precise prescription of the imaging planes, the implemented 4D-flow sequence allows for whole-chest coverage in ∼10-minute, free-breathing acquisition without the need for a navigator echo, which makes scan time independent of the patient’s breathing pattern. Furthermore, conventional myocardial tagging has been replaced by the fast strain-encoding (SENC) sequence, which reduces scan time from one slice per breath-hold to only one slice per heartbeat (∼1 second). Finally, T1 and T2 mapping sequences are included in this proposed exam, which allow for myocardial tissue characterization without the need for contrast. The proposed rapid exam has been tested on volunteers and measurements showed good agreement with those from conventional sequences despite the significant reduction in scan time.In conclusion, we propose a rapid, contrast-free, and comprehensive cardiovascular exam that does not require repeated breath-holds or a cardiac experienced operator to run the exam, which would result in improving cost effectiveness of CMR and increasing its adoption in clinical practice.

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Diagnostic Performance of Unenhanced Electrocardiogram-gated Cardiac CT for Myocardial Edema Using Cardiac T2 Mapping as a Reference Standard

10.21203/rs.3.rs-500731/v1 ◽

2021 ◽

Author(s):

Takafumi Emoto ◽

Masafumi Kidoh ◽

Seitaro Oda ◽

Daisuke Sakabe ◽

Kosuke Morita ◽

...

Keyword(s):

Diagnostic Performance ◽

Large Scale ◽

Tissue Characterization ◽

Cardiac Ct ◽

Volume Fraction ◽

T2 Mapping ◽

Characteristic Curve ◽

Extracellular Volume ◽

Myocardial Edema ◽

Reference Standard

Abstract Purpose To assess the diagnostic performance of unenhanced electrocardiogram (ECG)-gated cardiac CT for myocardial edema, using T2 mapping as the reference standard. Methods This study included 34 patients (23 men; age 64.7 ± 14.6 years) who underwent cardiac CT and MRI. On the unenhanced ECG-gated cardiac CT images, regions of interest (ROIs) were drawn on the septal myocardium. Using T2 mapping as the reference standard, the diagnostic performance of unenhanced cardiac CT for myocardial edema was evaluated by using the area under the receiver operating characteristic curve (AUC) with sensitivity and specificity. Results Mean CT values moderately correlated with mean T2 values (Rho = -0.41; P < 0.05). Mean CT values provided a sensitivity of 63.2% and a specificity of 93.3% for detecting myocardial edema, with a cut-off value of ≤ 45.0 HU (AUC = 0.77; P < 0.01). Inter-observer reproducibility in measuring mean CT values was excellent (ICC = 0.93; [95% CI: 0.86, 0.96]). Conclusion This is the first clinical study to assess the diagnostic performance of unenhanced ECG-gated cardiac CT for myocardial edema, using T2 mapping as the reference standard. Our study suggested that the CT value of myocardium in unenhanced ECG-gated cardiac CT may be an optional parameter in addition to late iodine enhancement and extracellular volume fraction for myocardial tissue characterization, but further prospective, large-scale clinical studies are needed.

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