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Non-contrast T1-mapping detects acute myocardial edema with high diagnostic accuracy: a comparison to T2-weighted cardiovascular magnetic resonance

Ferreira, Vanessa M ; Piechnik, Stefan K ; Dall'Armellina, Erica ; Karamitsos, Theodoros D ; Francis, Jane M ; Choudhury, Robin P ; Friedrich, Matthias G ; Robson, Matthew D ; Neubauer, Stefan

Journal of cardiovascular magnetic resonance, 2012-06, Vol.14 (1), p.42-42, Article 42 [Periódico revisado por pares]

England: BioMed Central Ltd

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Título:
Non-contrast T1-mapping detects acute myocardial edema with high diagnostic accuracy: a comparison to T2-weighted cardiovascular magnetic resonance
Autor: Ferreira, Vanessa M ; Piechnik, Stefan K ; Dall'Armellina, Erica ; Karamitsos, Theodoros D ; Francis, Jane M ; Choudhury, Robin P ; Friedrich, Matthias G ; Robson, Matthew D ; Neubauer, Stefan
Assuntos: Acute Disease ; Adult ; Aged ; Cardiology ; Cardiomyopathy ; Cardiovascular magnetic resonance ; Contrast Media ; Control equipment ; Diagnosis ; Diagnosis, Differential ; Diagnostic systems ; Dropsy ; Edema ; Edema, Cardiac - diagnosis ; Edema, Cardiac - etiology ; Edema, Cardiac - physiopathology ; Female ; Follow-Up Studies ; Heart diseases ; Humans ; Imaging ; Magnetic resonance imaging ; Magnetic Resonance Imaging, Cine - methods ; Male ; Middle Aged ; Muscles ; Myocardial Contraction ; Myocardial edema ; Myocardium ; Myocardium - pathology ; Patients ; Reproducibility of Results ; Segments ; ShMOLLI ; T1-mapping ; T2-weighted MRI ; Takotsubo Cardiomyopathy - complications ; Takotsubo Cardiomyopathy - diagnosis ; Takotsubo Cardiomyopathy - physiopathology
É parte de: Journal of cardiovascular magnetic resonance, 2012-06, Vol.14 (1), p.42-42, Article 42
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Descrição: T2w-CMR is used widely to assess myocardial edema. Quantitative T1-mapping is also sensitive to changes in free water content. We hypothesized that T1-mapping would have a higher diagnostic performance in detecting acute edema than dark-blood and bright-blood T2w-CMR. We investigated 21 controls (55 ± 13 years) and 21 patients (61 ± 10 years) with Takotsubo cardiomyopathy or acute regional myocardial edema without infarction. CMR performed within 7 days included cine, T1-mapping using ShMOLLI, dark-blood T2-STIR, bright-blood ACUT2E and LGE imaging. We analyzed wall motion, myocardial T1 values and T2 signal intensity (SI) ratio relative to both skeletal muscle and remote myocardium. All patients had acute cardiac symptoms, increased Troponin I (0.15-36.80 ug/L) and acute wall motion abnormalities but no LGE. T1 was increased in patient segments with abnormal and normal wall motion compared to controls (1113 ± 94 ms, 1029 ± 59 ms and 944 ± 17 ms, respectively; p < 0.001). T2 SI ratio using STIR and ACUT2E was also increased in patient segments with abnormal and normal wall motion compared to controls (all p < 0.02). Receiver operator characteristics analysis showed that T1-mapping had a significantly larger area-under-the-curve (AUC = 0.94) compared to T2-weighted methods, whether the reference ROI was skeletal muscle or remote myocardium (AUC = 0.58-0.89; p < 0.03). A T1 value of greater than 990 ms most optimally differentiated segments affected by edema from normal segments at 1.5 T, with a sensitivity and specificity of 92 %. Non-contrast T1-mapping using ShMOLLI is a novel method for objectively detecting myocardial edema with a high diagnostic performance. T1-mapping may serve as a complementary technique to T2-weighted imaging for assessing myocardial edema in ischemic and non-ischemic heart disease, such as quantifying area-at-risk and diagnosing myocarditis.
Editor: England: BioMed Central Ltd
Idioma: Inglês

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Non-contrast T1-mapping detects acute myocardial edema with high diagnostic accuracy: a comparison to T2-weighted cardiovascular magnetic resonance

Ferreira, Vanessa M ; Piechnik, Stefan K ; Dall'Armellina, Erica ; Karamitsos, Theodoros D ; Francis, Jane M ; Choudhury, Robin P ; Friedrich, Matthias G ; Robson, Matthew D ; Neubauer, Stefan

England: BioMed Central Ltd

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