Native T1 mapping to detect extent of acute and chronic myocardial infarction: comparison with late gadolinium enhancement technique

Abstract

Ducci, C. (2019). Native T1 mapping to detect extent of acute and chronic myocardial infarction: comparison with late gadolinium enhancement technique. Abstract Aim:Investigate whether native-T1 mapping can assess the transmural extent of myocardial infarction(TEI) thereby differentiating viable from non-viable myocardium without the use of gadolinium-contrast in both acute and chronic myocardial infarction(aMI and cMI). METHODS:60patients (30 cMI>1year and 30 aMI day2 STEMI) and 20 healthy-controls underwent 1.5T CMR to assess left ventricular function(cine), native-T1 mapping(MOLLI sequence 5(3)3, motion-corrected) and the presence and TEI from late gadolinium enhancement(LGE) images. Segments with <75% TEI was considered viable. Gold-standard LGE-TEI was compared with corresponding segmental native-T1. RESULTS:Segmental native-T1 correlated significantly with TEI(R= 0.74,p<0.001 in cMI and R=0.57,p<0.001 in aMI). Native-T1 differentiated segments with no LGE(1031±31ms), LGE positive but viable(1103±57ms) and LGE positive but non-viable(1206±118ms) in cMI(p<0.01). It also differentiated segments with no LGE(1054±65m), LGE positive but viable(1135±73ms) and LGE positive but non-viable(1168±71ms) in aMI(p<0.01). ROC analysis demonstrated excellent accuracy of native-T1 mapping compared to LGE-TEI(AUC-0.88,p <0.001 in cMI, vs AUC -0.83,p<0.001 in aMI). Native-T1 performed better in cMI than aMI(p<0.01). In cMI a segmental T1 threshold of 1085ms differentiated viable from nonviable segments with a sensitivity 88% and specificity of 88% whereas a T1 of 1110ms differentiated viable from nonviable with 79% sensitivity and 79% specificity in aMI. CONCLUSIONS:Native-T1 mapping correlates significantly with TEI thereby differentiating between normal, viable, and non-viable myocardium with distinctive T1 profiles in aMI and cMI. Native T1mapping to detect MI performed better in cMI compared to aMI due to absence of myocardial oedema. Native-T1 mapping holds promise for viability assessment without the need for gadolinium-contrast agent.

Quantitative T1 Mapping for Detecting Microvascular Obstruction in Reperfused Acute Myocardial Infarction: Comparison with Late Gadolinium Enhancement Imaging

“…Many studies have compared native T1 maps with LGE or T2-weighted images in terms of their ability to detect MI ( 2 9 10 11 15 16 ). However, a few studies have compared the utility of native or post-contrast T1 maps with that of LGE images for evaluating MVO ( 17 18 19 ).…”

Cardiovascular imaging 2019 in the International Journal of Cardiovascular Imaging

“…Lui et al found increased LV myocardial T1 and reduced strain in patients with hypothyroidism [63]. Dastidar et al found that native T1 mapping correlated well with LGE in patients with transmural myocardial infarction and could differentiate normal, viable and nonviable segments [64]. In related work van Assen et al found that T1 reactivity could discriminate between normal, ischemic and infarcted myocardium [65].…”

Recent Advances in Fibrosis and Scar Segmentation From Cardiac MRI: A State-of-the-Art Review and Future Perspectives

“…Non-CA modality based cardiac scar segmentation methods have been widely demonstrated for LV scar delineations but has not been realized for LA scar delineations. Dastidar et al (2019) and Liu et al (2018) demonstrated the potential of pre-contrast scar segmentation by comparing the inter-modality manual observations of myocardial infarction regions on LGE CMR and native-T1 mapping without the Gadolinium contrast agents.…”