Native T1 in Discrimination of Acute and Convalescent Stages in Patients With Clinical Diagnosis of Myocarditis

Hinojar, Rocío; Foote, Lucy; Arroyo-Úcar, Eduardo; Jackson, Tom; Jabbour, Andrew; Yu, Chung Yao; McCrohon, Jane; Higgins, David M.; Carr‐White, Gerry; Mayr, Manuel; Nagel, Eike; Püntmann, Valentina O.

doi:10.1016/j.jcmg.2014.07.016

Cited by 183 publications

(130 citation statements)

References 30 publications

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“…Much evidence supports the notion that T1-mapping indices are influenced by the presence of myocardial edema, such as in acute myocardial infarction, 60,61 acute 62-64 or chronic 63,65 or Takotsubo cardiomyopathy. 20 The recognition of acute inflammation by T1 mapping was shown to be superior to edema imaging with T2-weighted sequences [62][63][64] and to LGE.…”

Section: T1 Mapping In Myocardial Inflammationmentioning

confidence: 72%

T1 Mapping in Characterizing Myocardial Disease

Püntmann

Peker

Chandrashekhar

et al. 2016

Circulation Research

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247

202

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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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Section: T1 Mapping In Myocardial Inflammationmentioning

confidence: 72%

T1 Mapping in Characterizing Myocardial Disease

Püntmann

Peker

Chandrashekhar

et al. 2016

Circulation Research

Self Cite

247

202

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“…Moreover, it could be demonstrated by Ferreira et al in 50 patients with suspected acute myocarditis that native T1 mapping is superior to T2-weighted black blood imaging and LGE imaging in the detection of myocarditis regarding sensitivity when assuming a native T1 cut-off value of 990 ms [28]. Furthermore, in a study by Hinojar et al, native T1 mapping enabled not only differentiation between healthy subjects and myocardial inflammation, but also of acute myocardial inflammation and convalescent disease stages [29]. In a phantom study by Giri et al, T2 mapping offered the potential for increased accuracy in the detection of myocardial edema [30] and in a study by Thavendiranathan et al T2 mapping delineated a greater extent of myocardial disease in myocarditis and takotsubo cardiomyopathy compared to other sequences [16].…”

Section: Myocardial Inflammationmentioning

confidence: 99%

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

Roller¹,

Harth²,

Schneider³

et al. 2015

Fortschr Röntgenstr

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!Cardiac magnetic resonance imaging (CMRI) is a versatile diagnostic tool. One of its main advantages is the possibility of tissue characterization. T1-weighted images for scar and T2-weighted images for edema visualization are key methods for tissue characterization. Otherwise these sequences are strongly limited for the detection of diffuse myocardial pathologies. Recently, rapid technical innovations have generated new techniques. T1, T2 mapping and evaluation of the extracellular volume fraction (ECV) allow quantification of diffuse myocardial pathologies and showed great potential in the visualization of fibrosis, edema, amyloid, iron overload and lipid. In the future these techniques might enable the detection of early cardiac involvement, even act as a prognosticator. Moreover, therapy monitoring and follow-up might be possible due to versatile parameter quantification with these new techniques. Key points:▶ CMR allows for tissue characterization via T1-and T2-weighted sequences.▶ In cases of diffuse, global myocardial pathologies, correct image interpretation with traditional CMR sequences might be difficult.▶ T1, T2 mapping and ECV can quantify diffuse, global myocardial pathologies.

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“…In 2013, Ferreira et al demonstrated that patients suffering from acute MC had higher native myocardial T1 than healthy controls at 1.5 T [40]. In a large patient study Hinojar et al demonstrated the great potential of native T1 for detecting MC, and in this study a combination of native T1 and LGE performed even better [41]. In addition, the authors established cut-offs for native T1 in order to discriminate acute from chronic MC, thereby demonstrating a steady decline in native T1 as inflammation resolved.…”

Section: T1 Mappingmentioning

confidence: 51%

Modern Imaging of Myocarditis: Possibilities and Challenges

Baeßler

Schmidt

Lücke

et al. 2016

Fortschr Röntgenstr

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▼Myocarditis is known as the chameleon of cardiac diseases. The symptoms and the course of disease vary greatly so that it is often challenging to establish a diagnosis. Early and accurate diagnosis is of utmost importance, since myocarditis is one of the leading causes of sudden cardiac death in young adults and represents an important precursor to dilated cardiomyopathy. Due to the constraints of the routinely used diagnostic approach, including clinical history and examination, laboratory testing, and electrocardiogram, different imaging modalities have emerged over the last decades as contributors to the noninvasive diagnosis of myocarditis. With this interdisciplinary review we would like to present the current state-of-the-art imaging of myocarditis across all available imaging modalities (i. e., echocardiography, cardiac magnetic resonance, cardiac computed tomography, and nuclear medicine). Furthermore, we present novel imaging techniques that might become useful in the near future for easier and more accurate diagnosis of this highly relevant disease.

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Native T1 in Discrimination of Acute and Convalescent Stages in Patients With Clinical Diagnosis of Myocarditis

Abstract: The new diagnostic algorithm using native T1 can reliably discriminate between health and disease and determine the clinical disease stage in patients with a clinical diagnosis of myocarditis.

Cited by 183 publications

References 30 publications

T1 Mapping in Characterizing Myocardial Disease

T1 Mapping in Characterizing Myocardial Disease

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

Modern Imaging of Myocarditis: Possibilities and Challenges

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