Inversion time prolongation at late enhancement cardiac magnetic resonance in a myeloma patient

Abstract

A patient undergoing chemotherapy for multiple myeloma had a sudden onset of heart failure. Cardiac magnetic resonance was performed after echocardiography to rule out myocardial late enhancement, which was not detected. Interestingly, the inversion time of the T1-weighted inversion recovery late enhancement sequence needed to be significantly increased (from the usual 250-300 to 490 ms) to obtain diagnostic images. This report presents the clinical case of this patient, and discusses potential implications.

Quantitative evaluation of ischemic myocardial scar tissue by unenhanced T1 mapping using 3.0 Tesla MR scanner

“…T1 mapping makes it possible to bypass windowing and signal enhancement variations by calculating T1 relaxation times directly, compared to DE images. This in turn permits signal quantification (in milliseconds) of each myocardial voxel and subsequent standardized characterization of myocardial tissue (5).…”

“…In addition, with conventional DE-MRI sequences, signal intensity is expressed on an arbitrarily scale that differs from one imaging to another. Therefore, this method is not suitable for direct signal quantification (5). Furthermore, concerns about the increased risk of gadolinium-induced nephrogenic systemic fibrosis have increased gradually in populations with impaired renal function (6,7).…”