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Free-breathing T 2 mapping at 3T for the monitoring of cardiac allograft rejection: initial results

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The measurement of the T2 relaxation time has been suggested for detection of allograft rejection, on the pathophysiological basis that the T2 relaxation time prolongs with local edema resulting from acute allograft rejection... Using breath-held cardiac magnetic resonance T2 mapping at 1.5T, Usman et al. (CircCardiovascImaging2012) detected moderate allograft rejection (grade 2R, ISHLT 2004)... Eighteen patients received EMB (Tan et al., ArchPatholLabMed2007) and cardiac T2 mapping on the same day... Reading of T2 maps was blinded to the histological results... For final analysis, 3 cases with known 2R rejection at the time of T2 mapping were added, yielding 21 T2 mapping sessions... The degree of discrimination was determined using the Spearman's ranked correlation test... The high-quality T2 maps allowed for visual differentiation of the rejection degrees (Figure 1), and the correlation of T2 mapping with the histological grade of acute cellular rejection was significant (Spearman's ρ = 0.56, p = 0.007)... The 0R (n = 15) and 1R (n = 3) degrees demonstrated significantly different T2 values (46.9 ± 5.0 and 54.3 ± 3.0 ms, p = 0.02, Figure 2)... Cases with 2R rejection showed clear T2 elevation (T2 = 60.3 ± 16.2 ms)... This pilot study demonstrates that non-invasive free-breathing cardiac T2 mapping at 3T discriminates between no and mild cardiac allograft rejection... Confirmation of these encouraging results in a larger cohort should consider a study able to show equivalency or superiority of T2 mapping.

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Mid-ventricular short-axis T2 maps of varying degrees of rejection. The color bar (right side) indicates the T2 values in ms. a) No rejection (0R) in a 39-year-old female. b) Mild rejection (1R) in a 61-year-old male. c) Moderate rejection in a 66-year-old male.
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Figure 1: Mid-ventricular short-axis T2 maps of varying degrees of rejection. The color bar (right side) indicates the T2 values in ms. a) No rejection (0R) in a 39-year-old female. b) Mild rejection (1R) in a 61-year-old male. c) Moderate rejection in a 66-year-old male.

Mentions: The high-quality T2 maps allowed for visual differentiation of the rejection degrees (Figure 1), and the correlation of T2 mapping with the histological grade of acute cellular rejection was significant (Spearman's ρ = 0.56, p = 0.007). The 0R (n = 15) and 1R (n = 3) degrees demonstrated significantly different T2 values (46.9 ± 5.0 and 54.3 ± 3.0 ms, p = 0.02, Figure 2). Cases with 2R rejection showed clear T2 elevation (T2 = 60.3 ± 16.2 ms).


Free-breathing T 2 mapping at 3T for the monitoring of cardiac allograft rejection: initial results
Mid-ventricular short-axis T2 maps of varying degrees of rejection. The color bar (right side) indicates the T2 values in ms. a) No rejection (0R) in a 39-year-old female. b) Mild rejection (1R) in a 61-year-old male. c) Moderate rejection in a 66-year-old male.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4043701&req=5

Figure 1: Mid-ventricular short-axis T2 maps of varying degrees of rejection. The color bar (right side) indicates the T2 values in ms. a) No rejection (0R) in a 39-year-old female. b) Mild rejection (1R) in a 61-year-old male. c) Moderate rejection in a 66-year-old male.
Mentions: The high-quality T2 maps allowed for visual differentiation of the rejection degrees (Figure 1), and the correlation of T2 mapping with the histological grade of acute cellular rejection was significant (Spearman's ρ = 0.56, p = 0.007). The 0R (n = 15) and 1R (n = 3) degrees demonstrated significantly different T2 values (46.9 ± 5.0 and 54.3 ± 3.0 ms, p = 0.02, Figure 2). Cases with 2R rejection showed clear T2 elevation (T2 = 60.3 ± 16.2 ms).

View Article: PubMed Central - HTML

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

The measurement of the T2 relaxation time has been suggested for detection of allograft rejection, on the pathophysiological basis that the T2 relaxation time prolongs with local edema resulting from acute allograft rejection... Using breath-held cardiac magnetic resonance T2 mapping at 1.5T, Usman et al. (CircCardiovascImaging2012) detected moderate allograft rejection (grade 2R, ISHLT 2004)... Eighteen patients received EMB (Tan et al., ArchPatholLabMed2007) and cardiac T2 mapping on the same day... Reading of T2 maps was blinded to the histological results... For final analysis, 3 cases with known 2R rejection at the time of T2 mapping were added, yielding 21 T2 mapping sessions... The degree of discrimination was determined using the Spearman's ranked correlation test... The high-quality T2 maps allowed for visual differentiation of the rejection degrees (Figure 1), and the correlation of T2 mapping with the histological grade of acute cellular rejection was significant (Spearman's ρ = 0.56, p = 0.007)... The 0R (n = 15) and 1R (n = 3) degrees demonstrated significantly different T2 values (46.9 ± 5.0 and 54.3 ± 3.0 ms, p = 0.02, Figure 2)... Cases with 2R rejection showed clear T2 elevation (T2 = 60.3 ± 16.2 ms)... This pilot study demonstrates that non-invasive free-breathing cardiac T2 mapping at 3T discriminates between no and mild cardiac allograft rejection... Confirmation of these encouraging results in a larger cohort should consider a study able to show equivalency or superiority of T2 mapping.

No MeSH data available.


Related in: MedlinePlus