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T1 mapping: characterisation of myocardial interstitial space.

Perea RJ, Ortiz-Perez JT, Sole M, Cibeira MT, de Caralt TM, Prat-Gonzalez S, Bosch X, Berruezo A, Sanchez M, Blade J - Insights Imaging (2014)

Bottom Line: Myocardial fibrosis is always present in end-stage heart failure and is a major independent predictor of adverse cardiac outcome.T1 mapping techniques performed both with and without contrast enable the quantification of diffuse myocardial fibrosis and myocardial infiltration.This article reviews current imaging techniques, emerging applications and the future potential and limitations of CMR for T1 mapping. • Myocardial fibrosis is a common endpoint in a variety of cardiac diseases. • Myocardial fibrosis results in myocardial stiffness, heart failure, arrhythmia and sudden death. • T1-mapping CMR techniques enable the quantification of diffuse myocardial fibrosis. • Native T1 reflects myocardial disease involving the myocyte and interstitium. • The use of gadolinium allows measurement of the extracellular volume fraction, reflecting interstitial space.

View Article: PubMed Central - PubMed

Affiliation: Radiology Department. Hospital Clinic, University of Barcelona, Barcelona, Spain, rjperea@clinic.ub.es.

ABSTRACT

Unlabelled: Myocardial fibrosis is always present in end-stage heart failure and is a major independent predictor of adverse cardiac outcome. Cardiac magnetic resonance (CMR) is an imaging method that permits a non-invasive assessment of the heart and has been established as the "gold standard" for the evaluation of cardiac anatomy and function, as well as for quantifying focal myocardial fibrosis in both ischaemic and non-ischaemic heart disease. However, cardiac pathologies characterised by diffuse myocardial fibrosis cannot be evaluated by late gadolinium enhancement (LGE) imaging, as there are no reference regions of normal myocardium. Recent improvements in CMR imaging techniques have enabled parametric mapping of relaxation properties (T1, T2 and T2*) clinically feasible within a single breath-hold. T1 mapping techniques performed both with and without contrast enable the quantification of diffuse myocardial fibrosis and myocardial infiltration. This article reviews current imaging techniques, emerging applications and the future potential and limitations of CMR for T1 mapping.

Teaching points: • Myocardial fibrosis is a common endpoint in a variety of cardiac diseases. • Myocardial fibrosis results in myocardial stiffness, heart failure, arrhythmia and sudden death. • T1-mapping CMR techniques enable the quantification of diffuse myocardial fibrosis. • Native T1 reflects myocardial disease involving the myocyte and interstitium. • The use of gadolinium allows measurement of the extracellular volume fraction, reflecting interstitial space.

No MeSH data available.


Related in: MedlinePlus

Scarring or replacement fibrosis after myocardial infarction: a stellate fibrous scar (blue areas) replaces myocardial parenchyma (Masson trichrome staining ×40)
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Fig1: Scarring or replacement fibrosis after myocardial infarction: a stellate fibrous scar (blue areas) replaces myocardial parenchyma (Masson trichrome staining ×40)

Mentions: Replacement or scarring fibrosis corresponds to the replacement of myocytes after cell damage or necrosis by plexiform fibrosis [21]. It may have localised (Fig. 1) (ischaemic cardiomyopathy, myocarditis, hypertrophic cardiomyopathy and sarcoidosis) or diffuse distribution (chronic renal insufficiency, toxic cardiomyopathies and inflammatory diseases) depending on the underlying aetiology. The most common cause of replacement fibrosis is scarring from myocardial infarction. LGE is a validated way to identify focal replacement fibrosis [8].Fig. 1


T1 mapping: characterisation of myocardial interstitial space.

Perea RJ, Ortiz-Perez JT, Sole M, Cibeira MT, de Caralt TM, Prat-Gonzalez S, Bosch X, Berruezo A, Sanchez M, Blade J - Insights Imaging (2014)

Scarring or replacement fibrosis after myocardial infarction: a stellate fibrous scar (blue areas) replaces myocardial parenchyma (Masson trichrome staining ×40)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4376813&req=5

Fig1: Scarring or replacement fibrosis after myocardial infarction: a stellate fibrous scar (blue areas) replaces myocardial parenchyma (Masson trichrome staining ×40)
Mentions: Replacement or scarring fibrosis corresponds to the replacement of myocytes after cell damage or necrosis by plexiform fibrosis [21]. It may have localised (Fig. 1) (ischaemic cardiomyopathy, myocarditis, hypertrophic cardiomyopathy and sarcoidosis) or diffuse distribution (chronic renal insufficiency, toxic cardiomyopathies and inflammatory diseases) depending on the underlying aetiology. The most common cause of replacement fibrosis is scarring from myocardial infarction. LGE is a validated way to identify focal replacement fibrosis [8].Fig. 1

Bottom Line: Myocardial fibrosis is always present in end-stage heart failure and is a major independent predictor of adverse cardiac outcome.T1 mapping techniques performed both with and without contrast enable the quantification of diffuse myocardial fibrosis and myocardial infiltration.This article reviews current imaging techniques, emerging applications and the future potential and limitations of CMR for T1 mapping. • Myocardial fibrosis is a common endpoint in a variety of cardiac diseases. • Myocardial fibrosis results in myocardial stiffness, heart failure, arrhythmia and sudden death. • T1-mapping CMR techniques enable the quantification of diffuse myocardial fibrosis. • Native T1 reflects myocardial disease involving the myocyte and interstitium. • The use of gadolinium allows measurement of the extracellular volume fraction, reflecting interstitial space.

View Article: PubMed Central - PubMed

Affiliation: Radiology Department. Hospital Clinic, University of Barcelona, Barcelona, Spain, rjperea@clinic.ub.es.

ABSTRACT

Unlabelled: Myocardial fibrosis is always present in end-stage heart failure and is a major independent predictor of adverse cardiac outcome. Cardiac magnetic resonance (CMR) is an imaging method that permits a non-invasive assessment of the heart and has been established as the "gold standard" for the evaluation of cardiac anatomy and function, as well as for quantifying focal myocardial fibrosis in both ischaemic and non-ischaemic heart disease. However, cardiac pathologies characterised by diffuse myocardial fibrosis cannot be evaluated by late gadolinium enhancement (LGE) imaging, as there are no reference regions of normal myocardium. Recent improvements in CMR imaging techniques have enabled parametric mapping of relaxation properties (T1, T2 and T2*) clinically feasible within a single breath-hold. T1 mapping techniques performed both with and without contrast enable the quantification of diffuse myocardial fibrosis and myocardial infiltration. This article reviews current imaging techniques, emerging applications and the future potential and limitations of CMR for T1 mapping.

Teaching points: • Myocardial fibrosis is a common endpoint in a variety of cardiac diseases. • Myocardial fibrosis results in myocardial stiffness, heart failure, arrhythmia and sudden death. • T1-mapping CMR techniques enable the quantification of diffuse myocardial fibrosis. • Native T1 reflects myocardial disease involving the myocyte and interstitium. • The use of gadolinium allows measurement of the extracellular volume fraction, reflecting interstitial space.

No MeSH data available.


Related in: MedlinePlus