Cardiac MRI: T2-Mapping Versus T2-Weighted Dark-Blood TSE Imaging for Myocardial Edema Visualization in Acute Myocardial Infarction

Naßenstein, Kai; Nensa, Felix; Schlosser, Thomas; Bruder, Oliver; Umutlu, Lale; Lauenstein, Thomas C.; Maderwald, Stefan; Ladd, Mark E.

doi:10.1055/s-0033-1350516

Cited by 18 publications

(15 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, while correct interpretation of standard qualitative T2-w images is challenging in global edema due to the lack of healthy reference tissue, we demonstrated that diffuse myocardial edema as seen in patient #2 can be detected more easily with myocardial T2 mapping compared to qualitative T2-w imaging. Although some clinical studies already investigated the diagnostic value of myocardial T2 mapping in acute myocardial injury [ 11 , 25 , 28 ] more studies with well-defined study populations will be necessary to evaluate the clinic impact of myocardial T2 mapping [ 26 ]. Especially studies, with well-defined cohorts that use a longitudinal design will be necessary to investigate the benefits for monitoring therapy.…”

Section: Discussionmentioning

confidence: 99%

Gradient Spin Echo (GraSE) imaging for fast myocardial T2 mapping

Sprinkart

Luetkens

Träber

et al. 2015

Journal of Cardiovascular Magnetic Resonance

128

View full text Add to dashboard Cite

BackgroundQuantitative Cardiovascular Magnetic Resonance (CMR) techniques have gained high interest in CMR research. Myocardial T2 mapping is thought to be helpful in diagnosis of acute myocardial conditions associated with myocardial edema. In this study we aimed to establish a technique for myocardial T2 mapping based on gradient-spin-echo (GraSE) imaging.MethodsThe local ethics committee approved this prospective study. Written informed consent was obtained from all subjects prior to CMR. A modified GraSE sequence allowing for myocardial T2 mapping in a single breath-hold per slice using ECG-triggered acquisition of a black blood multi-echo series was developed at 1.5 Tesla. Myocardial T2 relaxation time (T2-RT) was determined by maximum likelihood estimation from magnitude phased-array multi-echo data. Four GraSE sequence variants with varying number of acquired echoes and resolution were evaluated in-vitro and in 20 healthy volunteers. Inter-study reproducibility was assessed in a subset of five volunteers. The sequence with the best overall performance was further evaluated by assessment of intra- and inter-observer agreement in all volunteers, and then implemented into the clinical CMR protocol of five patients with acute myocardial injury (myocarditis, takotsubo cardiomyopathy and myocardial infarction).ResultsIn-vitro studies revealed the need for well defined sequence settings to obtain accurate T2-RT measurements with GraSE. An optimized 6-echo GraSE sequence yielded an excellent agreement with the gold standard Carr-Purcell-Meiboom-Gill sequence. Global myocardial T2 relaxation times in healthy volunteers was 52.2 ± 2.0 ms (mean ± standard deviation). Mean difference between repeated examinations (n = 5) was −0.02 ms with 95% limits of agreement (LoA) of [−4.7; 4.7] ms. Intra-reader and inter-reader agreement was excellent with mean differences of −0.1 ms, 95% LoA = [−1.3; 1.2] ms and 0.1 ms, 95% LoA = [−1.5; 1.6] ms, respectively (n = 20). In patients with acute myocardial injury global myocardial T2-RTs were prolonged (mean: 61.3 ± 6.7 ms).ConclusionUsing an optimized GraSE sequence CMR allows for robust, reliable, fast myocardial T2 mapping and quantitative tissue characterization. Clinically, the GraSE-based T2-mapping has the potential to complement qualitative CMR in patients with acute myocardial injuries.Electronic supplementary materialThe online version of this article (doi:10.1186/s12968-015-0127-z) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Gradient Spin Echo (GraSE) imaging for fast myocardial T2 mapping

Sprinkart

Luetkens

Träber

et al. 2015

Journal of Cardiovascular Magnetic Resonance

128

View full text Add to dashboard Cite

show abstract

“…Mild and limited cutaneous SSc might present with less pathologic CMR findings per individual. No T 2 imaging was performed, but non-quantitative T 2 imaging cannot reliably depict diffuse edema [ 35 , 36 ] and edema has not been found in previous reports [ 10 ]. Neither T 1 nor T 2 - mapping were available at the time patients were examined.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular magnetic resonance patterns of biopsy proven cardiac involvement in systemic sclerosis

Krumm

Mueller

Klingel

et al. 2016

Journal of Cardiovascular Magnetic Resonance

View full text Add to dashboard Cite

BackgroundTo determine morphological and functional cardiovascular magnetic resonance (CMR) patterns in histopathologically confirmed myocardial involvement in patients with systemic sclerosis (SSc).MethodsTwenty patients (6 females; mean age 41 ± 11 years) with histopathologically proven cardiac involvement in SSc in the years 2008–2016 were retrospectively evaluated. Morphological, functional and late gadolinium enhancement (LGE) images were acquired in standard angulations at 1.5 T CMR. Pathologies were categorized: 1) Pericardial effusion; 2) pathologic left (LV) or right ventricular (RV) contractility (hypokinesia, dyssynchrony, and diastolic restriction); 3) reduced left (LV-EF) and right ventricular ejection fraction (RV-EF); 4) fibrosis and/or inflammation (positive LGE); 5) RV dilatation. 95 % confidence intervals (CI) were calculated for appearance of pathologic EF and RV dilatation.ResultsSeven patients (35 %) had positive CMR findings in three categories, 9 patients (45 %) in four categories and 4 patients (20 %) in five categories. The distribution of pathologic findings was: minimal pericardial effusion in 7 patients (35 %), moderate pericardial effusion >5 mm in nine patients (45 %); abnormal LV or RV contractility in 19 patients (95 %), reduced LV or RV function in 14 patients (70 %; 95 % CI: 51–88 %), pathologic LGE in all patients, RV dilatation in 6 patients (30 %; 95 % CI: 15–54 %).ConclusionsCMR diagnosis of myocardial involvement in SSc requires increased attention to subtle findings. Pathologic findings in at least three of five categories indicate myocardial involvement in SSc.Electronic supplementary materialThe online version of this article (doi:10.1186/s12968-016-0289-3) contains supplementary material, which is available to authorized users.

show abstract

“…values instead of differences in relative signal intensities (161). In fact T1 mapping may have superior performance to T2 mapping for the detection of acute myocardial oedema (162).…”

Section: Cmr Detection Of Oedemamentioning

confidence: 99%

Cardiovascular magnetic resonance in rheumatology: Current status and recommendations for use

Mavrogeni

Kitas

Dimitroulas

et al. 2016

International Journal of Cardiology

120

111

View full text Add to dashboard Cite

Targeted therapies in connective tissue diseases (CTDs) have led to improvements of disease-associated outcomes, but life expectancy remains lower compared to general population due to emerging co-morbidities, particularly due to excess cardiovascular risk. Cardiovascular magnetic resonance (CMR) is a noninvasive imaging technique which can provide detailed information about multiple cardiovascular pathologies without using ionizing radiation. CMR is considered the reference standard for quantitative evaluation of left and right ventricular volumes, mass and function, cardiac tissue characterization and assessment of thoracic vessels; it may also be used for the quantitative assessment of myocardial blood flow with high spatial resolution and for the evaluation of the proximal coronary arteries. These applications are of particular interest in CTDs, because of the potential of serious and variable involvement of the cardiovascular system during their course. The International Consensus Group on CMR in Rheumatology was formed in January 2012 aiming to achieve consensus among CMR and rheumatology experts in developing initial recommendations on the current state-of-the-art use of CMR in CTDs. The present report outlines the recommendations of the participating CMR and rheumatology experts with regards to: (a) indications for use of CMR in rheumatoid arthritis, the spondyloarthropathies, systemic lupus erythematosus, vasculitis of small, medium and large vessels, myositis, sarcoidosis (SRC), and scleroderma (SSc); (b) CMR protocols, terminology for reporting CMR and diagnostic CMR criteria for assessment and quantification of cardiovascular involvement in CTDs; and (c) a research agenda for the further development of this evolving field.

show abstract

Cardiac MRI: T2-Mapping Versus T2-Weighted Dark-Blood TSE Imaging for Myocardial Edema Visualization in Acute Myocardial Infarction

Cited by 18 publications

References 25 publications

Gradient Spin Echo (GraSE) imaging for fast myocardial T2 mapping

Gradient Spin Echo (GraSE) imaging for fast myocardial T2 mapping

Cardiovascular magnetic resonance patterns of biopsy proven cardiac involvement in systemic sclerosis

Cardiovascular magnetic resonance in rheumatology: Current status and recommendations for use

Contact Info

Product

Resources

About