Native T 1 Mapping by 3-T CMR Imaging for Characterization of Chronic Myocardial Infarctions

Kali, Avinash; Choi, Eui Young; Sharif, Behzad; Kim, Young Jin; Bi, Xiaoming; Spottiswoode, Bruce; Cokic, Ivan; Yang, Hsin Jung; Tighiouart, Mourad; Conte, Antonio Hernandez; Li, Debiao; Berman, Daniel S.; Choi, Byoung Wook; Chang, Hyuk Jae; Dharmakumar, Rohan

doi:10.1016/j.jcmg.2015.04.018

Cited by 80 publications

(69 citation statements)

References 34 publications

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“…38) These findings were correlated with results from endomyocardial biopsy in other studies. [39][40][41] Approaching a frequent dilemma in clinical practice, a recent study showed that native T1 clearly discriminates between HCM and hypertensive heart disease (HHD), with T1 values being significantly increased at the former.…”

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confidence: 78%

Native Myocardial T1 Mapping, Are We There Yet?

et al. 2016

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SummaryT1 or longitudinal relaxation time is one of the very fundamental magnetic resonance imaging (MRI) time constants and a tissue characterizing parameter. Only during the last decade did it become possible to quantify T1 values of the myocardium through T1 mapping. Evolving from only region of interest analysis and long acquisition times to the pixel-based parametric mapping and short breath-hold sequences, T1 mapping is reaching maturity among cardiac magnetic resonance (CMR) techniques. Both inversion recovery methods such as MOdified Look-Locker Inversion (MOL-LI) and Shortened MOLLI (ShMOLLI) and saturation recovery methods such as Saturation recovery Single-Shot Acquisition (SASHA) are available for T1 quantification with variable degrees of accuracy, precision, and reproducibility. Native (non-contrast) T1 values increase with edema, amyloid deposition, and fibrosis, while they decrease in fat or iron deposition in the myocardium. These features enabled significant expansion of the clinical applications of native T1 mapping where it provides high sensitivity and specificity and even acts as a disease biomarker or a predictor of prognosis. It is of particular usefulness in diffuse myocardial diseases where conventional CMR techniques might be deceiving. A brighter future for the technique is expected if certain challenges are to be faced, examples of which are the need for standardization of normal values, acquisition techniques, and improving analysis tools. (Int Heart J 2016; 57: 400-407)

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confidence: 78%

Native Myocardial T1 Mapping, Are We There Yet?

et al. 2016

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“…117 T1-mapping indices are also able to Cardiac event (hospitalizations for cardiovascular reasons, cardiac deaths), multivariate analyses were performed for imaging parameters separately; in the combined multivariate analysis clinical and imaging parameters, age, atrial fibrillation, previous CABG, and RV size were identified as the independent predictors; detect myocardial replacement scar, 40,118 although the exact delineation of the scar area remains challenging because of the presently insufficient spatial resolution and low signal to noise ratio. Finally, native T1 can reflect an increase in myocardial blood volume at rest as a compensatory mechanism for an increased resistance to blood flow because of a stenotic coronary artery, allowing recognition of ischemic areas.…”

Section: T1 Mapping In Acute Myocardial Ischemia and Infarctionmentioning

confidence: 99%

T1 Mapping in Characterizing Myocardial Disease

Püntmann

Peker

Chandrashekhar

et al. 2016

Circulation Research

270

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Cardiovascular magnetic resonance provides insights into myocardial structure and function noninvasively, with high diagnostic accuracy and without ionizing radiation. Myocardial tissue characterization in particular gives cardiovascular magnetic resonance a prime role among all the noninvasive cardiovascular investigations. Late gadolinium enhancement imaging is an established method for visualizing replacement scar, providing diagnostic and prognostic information in a variety of cardiac conditions. Late gadolinium enhancement, however, relies on the regional segregation of tissue characteristics to generate the imaging contrast. Thus, myocardial pathology that is diffuse in nature and affecting the myocardium in a rather uniform and global distribution is not well visualized with late gadolinium enhancement. Examples include diffuse myocardial inflammation, fibrosis, hypertrophy, and infiltration. T1 mapping is a novel technique allowing to diagnose these diffuse conditions by measurement of T1 values, which directly correspond to variation in intrinsic myocardial tissue properties. In addition to providing clinically meaningful indices, T1-mapping measurements also allow for an estimation of extracellular space by calculation of extracellular volume fraction. Multiple lines of evidence suggest a central role for T1 mapping in detection of diffuse myocardial disease in early disease stages and complements late gadolinium enhancement in visualization of the regional changes in common advanced myocardial disease. As a quantifiable measure, it may allow grading of disease activity, monitoring progress, and guiding treatment, potentially as a fast contrast-free clinical application. We present an overview of clinically relevant technical aspects of acquisition and processing, and the current state of art and evidence, supporting its clinical use.

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“…Recent studies have also investigated whether native T1-mapping (pre-contrast) can assess MI size. Kali and colleagues 44 showed that chronic MI (median of 13.6 years post-MI) could be detected using native T1-mapping at 3T in a small cohort of 25 patients. Liu and colleaguesl 45 showed that native T1-mapping at 3T could also identify acute MI size.…”

Section: Recent Advances In the Role Of Cmr In Reperfused Stemi Patientsmentioning

confidence: 99%

Cardiovascular Magnetic Resonance in Acute ST-Segment–Elevation Myocardial Infarction

et al. 2018

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While mortality following ST-segment elevation myocardial infarction (STEMI) is on the decline, the number of patients developing heart failure due to prior myocardial infarction (MI) is on the rise. Apart from timely reperfusion by primary percutaneous coronary intervention (PPCI), there is currently no established therapy for reducing MI size. As such new cardioprotective therapies are required to improve clinical outcomes following STEMI. Cardiovascular magnetic resonance (CMR) has emerged as an important imaging modality for assessing the efficacy of novel therapies for reducing MI size and preventing subsequent adverse left ventricular remodeling. The recent availability of multi-parametric mapping CMR has provided new insights into the pathophysiology underlying myocardial edema, microvascular obstruction, intramyocardial hemorrhage, and changes in the remote myocardial interstitial space following STEMI. In this article, we provide an overview of the recent advances in CMR imaging in reperfused STEMI patients, discuss the controversies surrounding its use, and explore future applications of CMR in this setting.

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Native T 1 Mapping by 3-T CMR Imaging for Characterization of Chronic Myocardial Infarctions

Abstract: Chronic MIs in STEMI and NSTEMI patients can be reliably characterized using threshold-based detection on native T1 maps at 3-T. Visual detection of chronic MIs on native T1 maps in both patient populations has high specificity, but modest sensitivity.

Cited by 80 publications

References 34 publications

Native Myocardial T1 Mapping, Are We There Yet?

Native Myocardial T1 Mapping, Are We There Yet?

T1 Mapping in Characterizing Myocardial Disease

Cardiovascular Magnetic Resonance in Acute ST-Segment–Elevation Myocardial Infarction

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