Histological Validation of measurement of diffuse interstitial myocardial fibrosis by myocardial extravascular volume fraction from Modified Look-Locker imaging MOLLI T1 mapping at 3 TReportar como inadecuado




Histological Validation of measurement of diffuse interstitial myocardial fibrosis by myocardial extravascular volume fraction from Modified Look-Locker imaging MOLLI T1 mapping at 3 T - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Journal of Cardiovascular Magnetic Resonance

, 17:48

First Online: 11 June 2015Received: 06 November 2014Accepted: 18 May 2015

Abstract

BackgroundGadolinium Gd Extracellular volume fraction ECV by Cardiovascular Magnetic Resonance CMR has been proposed as a non-invasive method for assessment of diffuse myocardial fibrosis.
Yet only few studies used 3 T CMR to measure ECV, and the accuracy of ECV measurements at 3 T has not been established.
Therefore the aims of the present study were to validate measurement of ECV by MOLLI T1 mapping by 3 T CMR against fibrosis measured by histopathology.
We also evaluated the recently proposed hypothesis that native-T1 mapping without contrast injection would be sufficient to detect fibrosis.

Methods31 patients age = 58 ± 17 years, 77 % men with either severe aortic stenosis n = 12 severe aortic regurgitation n = 9 or severe mitral regurgitation n = 10, all free of coronary artery disease, underwent 3 T-CMR with late gadolinium enhancement LGE and pre- and post-contrast MOLLI T1 mapping and ECV computation, prior to valve surgery.
LV biopsies were performed at the time of surgery, a median 13 1–30 days later, and stained with picrosirius red.
Pre-, and post-contrast T1 values, ECV, and amount of LGE were compared against magnitude of fibrosis by histopathology by Pearson correlation coefficients.

ResultsThe average amount of interstitial fibrosis by picrosirius red staining in biopsy samples was 6.1 ± 4.3 %.
ECV computed from pre-post contrast MOLLI T1 time changes was 28.9 ± 5.5 %, and correlated r = 0.78, p < 0.001 strongly with the magnitude of histological fibrosis.
By opposition, neither amount of LGE r = 0.17, p = 0.36 nor native pre-contrast myocardial T1 time r = −0.18, p = 0.32 correlated with fibrosis by histopathology.

ConclusionsECV determined by 3 T CMR T1 MOLLI images closely correlates with histologically determined diffuse interstitial fibrosis, providing a non-invasive estimation for quantification of interstitial fibrosis in patients with valve diseases.
By opposition, neither non-contrast T1 times nor the amount of LGE were indicative of the magnitude of diffuse interstitial fibrosis measured by histopathology.

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Autor: Christophe de Meester de Ravenstein - Caroline Bouzin - Siham Lazam - Jamila Boulif - Mihaela Amzulescu - Julie Melchior - A

Fuente: https://link.springer.com/article/10.1186/s12968-015-0150-0



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