T1, T2 Mapping and Extracellular Volume Fraction (ECV): Application, Value and Further Perspectives in Myocardial Inflammation and Cardiomyopathies

Roller, Fritz; Harth, Sebastian; Schneider, Christian; Krombach, Gabriele A.

doi:10.1055/s-0034-1399546

Cited by 39 publications

(27 citation statements)

References 56 publications

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“…Surely the role of isolated T2-weighted imaging has to be recognized as limited in the diagnosis of myocarditis. Newer results of T1 and T2 mapping for the diagnosis of myocarditis sound promising for the future, because of the resulting better standardization and objectification in T1 and T2 imaging [31,32].…”

Section: Tissue Characterizationmentioning

confidence: 99%

Functional and Morphological Parameters with Tissue Characterization of Cardiovascular Magnetic Imaging in Clinically Verified “Infarct-like Myocarditis”

Schwab¹,

Rogg²,

Pauschinger³

et al. 2015

Fortschr Röntgenstr

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Purpose: Cardiac magnetic resonance (CMR) has increasingly proved to be a valuable diagnostic tool for evaluating patients with suspected myocarditis. The objective of this study was to evaluate the diagnostic value of functional and morphological parameters including tissue characterization in patients with ?infarct-like myocarditis?. Materials and Methods: 43 patients with clinically verified cases of ?infarct-like myocarditis? (median time to MRI scanning after admission for acute symptoms 3 days) and 35 control patients matched by age and sex were included in this retrospective case control study. In this study we used a 1.5?T MRI scanner conducting steady-state-free-precession sequences, T2-weighted imaging, T1-weighted imaging before and after contrast administration and late gadolinium enhancement sequences. According to the recommendations for CMR diagnosis of myocarditis (Lake Louise consensus criteria), a scan was positive for acute myocarditis if 2 of 3 CMR criteria were present. Results: 30?% of the patients with ?infarct-like myocarditis? had a reduced left ventricular ejection fraction, 11?% had an increased LV end-diastolic volume index and 35?% had an increased LV mass index. The sensitivity of wall motion abnormalities was 63?% with a regional distribution in 49?%. In 47?% of cases regional wall motion abnormalities were present in the lateral left ventricular segments. Pericardial effusions were discovered in 65?% of cases with a circular appearance in 21?% and focal manifestation in 44?%. The diagnostic sensitivity, specificity, and accuracy of CMR in patients with ?infarct-like myocarditis? were 67?%, 100?% and 82?%, respectively. The LGE alone was the most sensitive test parameter with 86?%, providing a specificity of 100?% and accuracy of 92?%. Conclusion: Our study results can be applied to the subgroup of patients with ?infarct-like myocarditis?, where we found that LGE alone was the most sensitive test parameter. In addition to tissue characterization, the functional and morphological analysis of patients with acute myocarditis provides a useful further diagnostic tool. Key Points: ??Infarct-like myocarditis can be diagnosed by CMR with high validity and reliability. ??LGE allone performed best with a sensitivity of 86?%. ??Functional and morphological CMR parameters in addition to tissue characterization are useful tool in the diagnosis of acute myocarditis. Citation Format: ??Schwab J, Rogg H-J, Pauschinger M et?al. Functional and Morphological Parameters with Tissue Characterization of Cardiovascular Magnetic Imaging in Clinically Verified ?Infarct-like Myocarditis?. Fortschr R?ntgenstr 2016; 188: 365???373

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Section: Tissue Characterizationmentioning

confidence: 99%

Functional and Morphological Parameters with Tissue Characterization of Cardiovascular Magnetic Imaging in Clinically Verified “Infarct-like Myocarditis”

Schwab¹,

Rogg²,

Pauschinger³

et al. 2015

Fortschr Röntgenstr

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“…MRI has long been used as a diagnostic tool, taking advantage of the MR signal’s dependence on underlying tissue properties, such as relaxation times and spin density, to provide natural contrast between tissue types. While many MR experiments are designed to provide qualitative weighting for a particular property, quantitative mapping is a useful diagnostic tool, for example, in oncology, cardiology, and neurology …”

Section: Introductionmentioning

confidence: 99%

Parameter map error due to normal noise and aliasing artifacts in MR fingerprinting

Kara

Fan

Hamilton

et al. 2019

Magnetic Resonance in Med

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Purpose To introduce a quantitative tool that enables rapid forecasting of T1 and T2 parameter map errors due to normal and aliasing noise as a function of the MR fingerprinting (MRF) sequence, which can be used in sequence optimization. Theory and Methods The variances of normal noise and aliasing artifacts in the collected signal are related to the variances in T1 and T2 maps through derived quality factors. This analytical result is tested against the results of a Monte‐Carlo approach for analyzing MRF sequence encoding capability in the presence of aliasing noise, and verified with phantom experiments at 3 T. To further show the utility of our approach, our quality factors are used to find efficient MRF sequences for fewer repetitions. Results Experimental results verify the ability of our quality factors to rapidly assess the efficiency of an MRF sequence in the presence of both normal and aliasing noise. Quality factor assessment of MRF sequences is in agreement with the results of a Monte‐Carlo approach. Analysis of MRF parameter map errors from phantom experiments is consistent with the derived quality factors, with T1 (T2) data yielding goodness of fit R2 ≥ 0.92 (0.80). In phantom and in vivo experiments, the efficient pulse sequence, determined through quality factor maximization, led to comparable or improved accuracy and precision relative to a longer sequence, demonstrating quality factor utility in MRF sequence design. Conclusion The here introduced quality factor framework allows for rapid analysis and optimization of MRF sequence design through T1 and T2 error forecasting.

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“…Therefore, myocardial edema is the main pathology responsible for variation in T2 values. T2 mapping sequences are useful for the detection of myocardial edema in patients with acute myocardial infarction (AMI) (22), myocarditis (2324), stress cardiomyopathy (23), sarcoidosis (25), and cardiac allograft rejection (26). Normal myocardial T2 values acquired using steady-state free precession (SSFP) MR imaging have been reported to be 52.18 ± 3.4 ms at 1.5T (27) and 45.1 ms at 3T (28).…”

Section: T1 and T2 Mapping Parametersmentioning

confidence: 99%

Myocardial T1 and T2 Mapping: Techniques and Clinical Applications

et al. 2017

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Cardiac magnetic resonance (CMR) imaging is widely used in various medical fields related to cardiovascular diseases. Rapid technological innovations in magnetic resonance imaging in recent times have resulted in the development of new techniques for CMR imaging. T1 and T2 image mapping sequences enable the direct quantification of T1, T2, and extracellular volume fraction (ECV) values of the myocardium, leading to the progressive integration of these sequences into routine CMR settings. Currently, T1, T2, and ECV values are being recognized as not only robust biomarkers for diagnosis of cardiomyopathies, but also predictive factors for treatment monitoring and prognosis. In this study, we have reviewed various T1 and T2 mapping sequence techniques and their clinical applications.

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T1, T2 Mapping and Extracellular Volume Fraction (ECV): Application, Value and Further Perspectives in Myocardial Inflammation and Cardiomyopathies

Cited by 39 publications

References 56 publications

Functional and Morphological Parameters with Tissue Characterization of Cardiovascular Magnetic Imaging in Clinically Verified “Infarct-like Myocarditis”

Functional and Morphological Parameters with Tissue Characterization of Cardiovascular Magnetic Imaging in Clinically Verified “Infarct-like Myocarditis”

Parameter map error due to normal noise and aliasing artifacts in MR fingerprinting

Myocardial T1 and T2 Mapping: Techniques and Clinical Applications

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