Myocardial T2 mapping reveals age- and sex-related differences in volunteers

Abstract

BackgroundT2 mapping indicates to be a sensitive method for detection of tissue oedema hidden beyond the detection limits of T2-weighted Cardiovascular Magnetic Resonance (CMR). However, due to variability of baseline T2 values in volunteers, reference values need to be defined. Therefore, the aim of the study was to investigate the effects of age and sex on quantitative T2 mapping with a turbo gradient-spin-echo (GRASE) sequence at 1.5 T. For that reason, we studied sensitivity issues as well as technical and biological effects on GRASE-derived myocardial T2 maps. Furthermore, intra- and interobserver variability were calculated using data from a large volunteer group.MethodsGRASE-derived multiecho images were analysed using dedicated software. After sequence optimization, validation and sensitivity measurements were performed in muscle phantoms ex vivo and in vivo. The optimized parameters were used to analyse CMR images of 74 volunteers of mixed sex and a wide range of age with typical prevalence of hypertension and diabetes. Myocardial T2 values were analysed globally and according to the 17 segment model. Strain-encoded (SENC) imaging was additionally performed to investigate possible effects of myocardial strain on global or segmental T2 values.ResultsEx vivo studies in muscle phantoms showed, that GRASE-derived T2 values were comparable to those acquired by a standard multiecho spinecho sequence but faster by a factor of 6. Besides that, T2 values reflected tissue water content. The in vivo measurements in volunteers revealed intra- and interobserver correlations with R2=0.91 and R2=0.94 as well as a coefficients of variation of 2.4% and 2.2%, respectively. While global T2 time significantly decreased towards the heart basis, female volunteers had significant higher T2 time irrespective of myocardial region. We found no correlation of segmental T2 values with maximal systolic, diastolic strain or heart rate. Interestingly, volunteers´ age was significantly correlated to T2 time while that was not the case for other coincident cardiovascular risk factors.ConclusionGRASE-derived T2 maps are highly reproducible. However, female sex and aging with typical prevalence of hypertension and diabetes were accompanied by increased myocardial T2 values. Thus, sex and age must be considered as influence factors when using GRASE in a diagnostic manner.Electronic supplementary materialThe online version of this article (doi:10.1186/s12968-015-0118-0) contains supplementary material, which is available to authorized users.

Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: A consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI)

“…In a study of 342 healthy subjects, native T1 values of women were higher up to the age of 45 years [70]. Similarly, a study in 74 healthy subjects revealed higher myocardial T2 in women and in subjects with greater age [47, 71]. Further insights are expected from on-going other population-based studies [72].…”

High-sensitive troponin is associated with subclinical imaging biosignature of inflammatory cardiovascular involvement in systemic lupus erythematosus

“…T1 mapping was performed using modified Look-Locker imaging 30 31. For T2 mapping, a hybrid gradient and spin echo (GraSE) sequence was used at the London site,32 whereas in Frankfurt T2 mapping fast low angle shot (FLASH) sequence was employed 33 34. All sequence types and parameters have been validated and reported previously 12 18 20.…”

Abnormal T2 mapping cardiovascular magnetic resonance correlates with adverse clinical outcome in patients with suspected acute myocarditis

“…T2 maps were generated according to Bönner et al [15]. T2 maps were generated off-line using software based on the graphical programming language LabVIEW (National Instruments, Austin, TX).…”

“…Recently, we demonstrated increased T2 values in patients with biopsy-proven acute myocarditis (bpAMC) compared to age and gender matched controls [10, 15]. Furthermore, we proposed a diagnostic approach quantifying the extent of myocardium with pathologically elevated T2 time expressed as percentage of whole myocardium, thus taking accumulating regional inflammation into account.…”