Extracellular volume fraction mapping in the myocardium, part 2: initial clinical experience

Diffuse myocardial fibrosis, and to a lesser extent global myocardial edema, are important processes in heart disease which are difficult to assess or quantify with cardiovascular magnetic resonance (CMR) using conventional late gadolinium enhancement (LGE) or T1-mapping. Measurement of the myocardi...

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Bibliographic Details
Published in:Journal of cardiovascular magnetic resonance 2012-09, Vol.14 (1), p.64-64, Article 61
Main Authors: Kellman, Peter, Wilson, Joel R, Xue, Hui, Bandettini, W Patricia, Shanbhag, Sujata M, Druey, Kirk M, Ugander, Martin, Arai, Andrew E
Format: Article
Language:English
Subjects:
Adult
Aged
Amyloidosis
Cardiac patients
Diagnosis
Diffusion
Dilated cardiomyopathy
Edema
Elevated
Female
Fibrosis
Follow-Up Studies
Gadolinium
Heart attack
Heart diseases
Heart Diseases - pathology
Humans
Hypertrophic cardiomyopathy
Leaks
Magnetic resonance
Magnetic resonance imaging
Magnetic Resonance Imaging, Cine - methods
Male
Medical research
Medicin och hälsovetenskap
Medicine, Experimental
Middle Aged
Myocardial infarction
Myocarditis
Myocardium - pathology
Patients
Retrospective Studies
Systemic capillary leak syndrome
Volume fraction
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Summary:Diffuse myocardial fibrosis, and to a lesser extent global myocardial edema, are important processes in heart disease which are difficult to assess or quantify with cardiovascular magnetic resonance (CMR) using conventional late gadolinium enhancement (LGE) or T1-mapping. Measurement of the myocardial extracellular volume fraction (ECV) circumvents factors that confound T1-weighted images or T1-maps. We hypothesized that quantitative assessment of myocardial ECV would be clinically useful for detecting both focal and diffuse myocardial abnormalities in a variety of common and uncommon heart diseases. A total of 156 subjects were imaged including 62 with normal findings, 33 patients with chronic myocardial infarction (MI), 33 with hypertrophic cardiomyopathy (HCM), 15 with non-ischemic dilated cardiomyopathy (DCM), 7 with acute myocarditis, 4 with cardiac amyloidosis, and 2 with systemic capillary leak syndrome (SCLS). Motion corrected ECV maps were generated automatically from T1-maps acquired pre- and post-contrast calibrated by blood hematocrit. Abnormally-elevated ECV was defined as >2SD from the mean ECV in individuals with normal findings. In HCM the size of regions of LGE was quantified as the region >2 SD from remote. Mean ECV of 62 normal individuals was 25.4 ± 2.5% (m ± SD), normal range 20.4%-30.4%. Mean ECV within the core of chronic myocardial infarctions (without MVO) (N=33) measured 68.5 ± 8.6% (p
ISSN:1097-6647
1532-429X
1532-429X
DOI:10.1186/1532-429x-14-64