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Advanced Cardiac MR Imaging for Myocardial Characterization and Quantification: T1 Mapping.

Hwang SH, Choi BW - Korean Circ J (2013)

Bottom Line: Although late gadolinium enhancement after injection of the gadolinium extracellular contrast agent has further extended our ability to characterize the myocardial tissue, it also has limitations in the quantification of enhanced myocardial tissue pathology, and the detection of diffuse myocardial disease, which is not easily recognized by enhancement contrast.Recently, the remarkable advances in CMR technique, such as T1 mapping, which can quantitatively evaluate myocardial status, showed potentials to overcome limitations of existing CMR sequences and to expand the application of CMR.This article will review the technical and clinical points to be considered in the practical use of pre- and post-contrast T1 mapping.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
Magnetic resonance as an imaging modality provides an excellent soft tissue differentiation, which is an ideal choice for cardiac imaging. Cardiac magnetic resonance (CMR) allows myocardial tissue characterization, as well as comprehensive evaluation of the structures. Although late gadolinium enhancement after injection of the gadolinium extracellular contrast agent has further extended our ability to characterize the myocardial tissue, it also has limitations in the quantification of enhanced myocardial tissue pathology, and the detection of diffuse myocardial disease, which is not easily recognized by enhancement contrast. Recently, the remarkable advances in CMR technique, such as T1 mapping, which can quantitatively evaluate myocardial status, showed potentials to overcome limitations of existing CMR sequences and to expand the application of CMR. This article will review the technical and clinical points to be considered in the practical use of pre- and post-contrast T1 mapping.

No MeSH data available.


Related in: MedlinePlus

Late gadolinium enhancement (LGE) (A), pre- and post-contrast (B and C) T1 map images using 3-T MR system in a patient with esoniophilic myocarditis diagnosed by the biopsy. LGE-MR image shows no remarkable late gadolinium enhancement in the myocardium. Pre-contrast T1 map image shows the prolongation of T1 value in the focal area of mid ventricular septum, compared to the lateral wall. It can suggest the probable edema in the myocardium. Post-contrast T1 mapping show diffusely low T1 value (mean±standard deviation, 410.4±34.4 msec) from gadolinium-induced T1 shortening in the myocardium. Myocardial extracellular volume fraction calculated by the T1 mapping results is 33.5% which is higher than that in normal control in the literature.
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Figure 3: Late gadolinium enhancement (LGE) (A), pre- and post-contrast (B and C) T1 map images using 3-T MR system in a patient with esoniophilic myocarditis diagnosed by the biopsy. LGE-MR image shows no remarkable late gadolinium enhancement in the myocardium. Pre-contrast T1 map image shows the prolongation of T1 value in the focal area of mid ventricular septum, compared to the lateral wall. It can suggest the probable edema in the myocardium. Post-contrast T1 mapping show diffusely low T1 value (mean±standard deviation, 410.4±34.4 msec) from gadolinium-induced T1 shortening in the myocardium. Myocardial extracellular volume fraction calculated by the T1 mapping results is 33.5% which is higher than that in normal control in the literature.

Mentions: Although myocarditis is represented by myocardial inflammation, temporary pathologic status, according to disease progression or severity varies from edema to necrosis or fibrosis. T2WI of CMR is quite sensitive to detect regional myocardial edema in active myocarditis. LGE is a standard noninvasive imaging technique to evaluate irreversible myocardial injury related to myocarditis. However, diffuse or mild regional myocarditis typically in early or borderline disease may not be detected with T2-weighted imaging or LGE. Recently, a study reported that pre-contrast T1 mapping was sensitive to diagnose acute myocarditis that was CMR diagnosis based on T2-weighted imaging and LGE.43) With combination of pre-contrast and post-contrast T1 mapping, early detection and quantification of water contents or extracellular space will be feasible in myocarditis (Fig. 3).


Advanced Cardiac MR Imaging for Myocardial Characterization and Quantification: T1 Mapping.

Hwang SH, Choi BW - Korean Circ J (2013)

Late gadolinium enhancement (LGE) (A), pre- and post-contrast (B and C) T1 map images using 3-T MR system in a patient with esoniophilic myocarditis diagnosed by the biopsy. LGE-MR image shows no remarkable late gadolinium enhancement in the myocardium. Pre-contrast T1 map image shows the prolongation of T1 value in the focal area of mid ventricular septum, compared to the lateral wall. It can suggest the probable edema in the myocardium. Post-contrast T1 mapping show diffusely low T1 value (mean±standard deviation, 410.4±34.4 msec) from gadolinium-induced T1 shortening in the myocardium. Myocardial extracellular volume fraction calculated by the T1 mapping results is 33.5% which is higher than that in normal control in the literature.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3569561&req=5

Figure 3: Late gadolinium enhancement (LGE) (A), pre- and post-contrast (B and C) T1 map images using 3-T MR system in a patient with esoniophilic myocarditis diagnosed by the biopsy. LGE-MR image shows no remarkable late gadolinium enhancement in the myocardium. Pre-contrast T1 map image shows the prolongation of T1 value in the focal area of mid ventricular septum, compared to the lateral wall. It can suggest the probable edema in the myocardium. Post-contrast T1 mapping show diffusely low T1 value (mean±standard deviation, 410.4±34.4 msec) from gadolinium-induced T1 shortening in the myocardium. Myocardial extracellular volume fraction calculated by the T1 mapping results is 33.5% which is higher than that in normal control in the literature.
Mentions: Although myocarditis is represented by myocardial inflammation, temporary pathologic status, according to disease progression or severity varies from edema to necrosis or fibrosis. T2WI of CMR is quite sensitive to detect regional myocardial edema in active myocarditis. LGE is a standard noninvasive imaging technique to evaluate irreversible myocardial injury related to myocarditis. However, diffuse or mild regional myocarditis typically in early or borderline disease may not be detected with T2-weighted imaging or LGE. Recently, a study reported that pre-contrast T1 mapping was sensitive to diagnose acute myocarditis that was CMR diagnosis based on T2-weighted imaging and LGE.43) With combination of pre-contrast and post-contrast T1 mapping, early detection and quantification of water contents or extracellular space will be feasible in myocarditis (Fig. 3).

Bottom Line: Although late gadolinium enhancement after injection of the gadolinium extracellular contrast agent has further extended our ability to characterize the myocardial tissue, it also has limitations in the quantification of enhanced myocardial tissue pathology, and the detection of diffuse myocardial disease, which is not easily recognized by enhancement contrast.Recently, the remarkable advances in CMR technique, such as T1 mapping, which can quantitatively evaluate myocardial status, showed potentials to overcome limitations of existing CMR sequences and to expand the application of CMR.This article will review the technical and clinical points to be considered in the practical use of pre- and post-contrast T1 mapping.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
Magnetic resonance as an imaging modality provides an excellent soft tissue differentiation, which is an ideal choice for cardiac imaging. Cardiac magnetic resonance (CMR) allows myocardial tissue characterization, as well as comprehensive evaluation of the structures. Although late gadolinium enhancement after injection of the gadolinium extracellular contrast agent has further extended our ability to characterize the myocardial tissue, it also has limitations in the quantification of enhanced myocardial tissue pathology, and the detection of diffuse myocardial disease, which is not easily recognized by enhancement contrast. Recently, the remarkable advances in CMR technique, such as T1 mapping, which can quantitatively evaluate myocardial status, showed potentials to overcome limitations of existing CMR sequences and to expand the application of CMR. This article will review the technical and clinical points to be considered in the practical use of pre- and post-contrast T1 mapping.

No MeSH data available.


Related in: MedlinePlus