Myocardial edema during chemotherapy for gynecologic malignancies: A cardiac magnetic resonance T2 mapping study

Abstract

ObjectiveMyocardial edema is an early manifestation of chemotherapy-related myocardial injury. In this study, we used cardiac magnetic resonance (CMR) T2 mapping to assess myocardial edema and its changes during chemotherapy for gynecologic malignancies.MethodsWe enrolled 73 patients receiving chemotherapy for gynecologic malignancies, whose the latest cycle was within one month before the beginning of this study, and 41 healthy volunteers. All participants underwent CMR imaging. Of the 73 patients, 35 completed CMR follow-up after a median interval of 6 (3.3 to 9.6) months. The CMR sequences included cardiac cine, T2 mapping, and late gadolinium enhancement.ResultsMyocardial T2 was elevated in patients who were treated with chemotherapy compared with healthy volunteers [41ms (40ms to 43ms) vs. 41ms (39ms to 41ms), P = 0.030]. During follow-up, myocardial T2 rose further [40ms (39ms to 42ms) vs. 42.70 ± 2.92ms, P < 0.001]. Multivariate analysis showed that the number of chemotherapy cycles was associated with myocardial T2 elevation (β = 0.204, P = 0.029). After adjustment for other confounders, myocardial T2 elevation was independently associated with a decrease in left ventricular mass (β = −0.186; P = 0.024).ConclusionIn patients with gynecologic malignancies, myocardial edema developed with chemotherapy cycles increase, and was associated with left ventricular mass decrease. T2 mapping allows the assessment of myocardial edema and monitoring of its change during chemotherapy.

Quantitative Assessment of Myocardial Edema by MR T2 Mapping in Children With Kawasaki Disease

“…All KD patients enrolled in the study underwent CMRA, and the internal diameters of the left main coronary artery, left anterior descending artery (LAD), left circumflex artery (LCX) and RCA were measured. Moreover, the coronary Z scores were calculated with the internal diameters of different coronary arteries, sex, height, and weight of KD patients 21 . According to AHA guidelines, 1 Z scores of >2.0, 2.0–2.5, 2.5–5.0, and 5.0–10.0 and an absolute dimension of <8.0 mm and ≥10.0 or an absolute dimension of ≥8 mm were defined as CA dilation, dilation only, small aneurysm, medium aneurysm, and large aneurysm, respectively.…”

“…Moreover, the coronary Z scores were calculated with the internal diameters of different coronary arteries, sex, height, and weight of KD patients. 21 According to AHA guidelines, 1 Z scores of >2.0, 2.0-2.5, 2.5-5.0, and 5.0-10.0 and an absolute dimension of <8.0 mm and ≥10.0 or an absolute dimension of ≥8 mm were defined as CA dilation, dilation only, small aneurysm, medium aneurysm, and large aneurysm, respectively.…”

The value of multimodal functional magnetic resonance imaging in differentiating p53abn from p53wt endometrial carcinoma

“…In uterine tumours, the mDIXON-Quant has been used to quantitatively identify squamous cervical cancer grading (24). On the other hand, T2 quantitative imaging (T2 mapping) sequence reflects the tissue's characteristics and can assess tissue's free water content (25). Ge et al (26) found that T2 mapping was highly effective in the quantitative detection of lymph node metastasis in rectal cancer.…”