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Journal of Cardiovascular Magnetic Resonance

, 16:104

First Online: 20 December 2014Received: 06 June 2014Accepted: 01 December 2014

Abstract

BackgroundDetection of cardiac fibrosis based on endogenous magnetic resonance MR characteristics of the myocardium would yield a measurement that can provide quantitative information, is independent of contrast agent concentration, renal function and timing. In ex vivo myocardial infarction MI tissue, it has been shown that a significantly higher T1ρ is found in the MI region, and studies in animal models of chronic MI showed the first in vivo evidence for the ability to detect myocardial fibrosis with native T1ρ-mapping. In this study we aimed to translate and validate T1ρ-mapping for endogenous detection of chronic MI in patients.

MethodsWe first performed a study in a porcine animal model of chronic MI to validate the implementation of T1ρ-mapping on a clinical cardiovascular MR scanner and studied the correlation with histology. Subsequently a clinical protocol was developed, to assess the feasibility of scar tissue detection with native T1ρ-mapping in patients n = 21 with chronic MI, and correlated with gold standard late gadolinium enhancement LGE CMR. Four T1ρ-weighted images were acquired using a spin-lock preparation pulse with varying duration 0, 13, 27, 45 ms and an amplitude of 750 Hz, and a T1ρ-map was calculated. The resulting T1ρ-maps and LGE images were scored qualitatively for the presence and extent of myocardial scarring using the 17-segment AHA model.

ResultsIn the animal model n = 9 a significantly higher T1ρ relaxation time was found in the infarct region 61 ± 11 ms, compared to healthy remote myocardium 36 ± 4 ms . In patients a higher T1ρ relaxation time 79 ± 11 ms was found in the infarct region than in remote myocardium 54 ± 6 ms. Overlap in the scoring of scar tissue on LGE images and T1ρ-maps was 74%.

ConclusionWe have shown the feasibility of native T1ρ-mapping for detection of infarct area in patients with a chronic myocardial infarction. In the near future, improvements on the T1ρ -mapping sequence could provide a higher sensitivity and specificity. This endogenous method could be an alternative for LGE imaging, and provide additional quantitative information on myocardial tissue characteristics.

KeywordsHeart Fibrosis Heart failure Cardiovascular magnetic resonance Endogenous contrast T1ρ-mapping T1-mapping MOLLI Spin-lock Native contrast AbbreviationsMIMyocardial infarction

LGELate gadolinium enhancement

CAContrast agent

CMRCardiovascular Magnetic Resonance

LADLeft anterior descending

NSANumber of signals averaged

SLSpin lock

FOVField of view

SSFPSteady-state free precession

TEEcho time

TRRepetition time

Electronic supplementary materialThe online version of this article doi:10.1186-s12968-014-0104-y contains supplementary material, which is available to authorized users.

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Autor: Joep WM van Oorschot - Hamza El Aidi - Sanne J Jansen of Lorkeers - Johannes MIH Gho - Martijn Froeling - Fredy Visser -

Fuente: https://link.springer.com/article/10.1186/s12968-014-0104-y

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