T1 mapping in cardiomyopathy by cardiac magnetic resonance: Comparison to endomyocardial biopsy

Thursday, October 11, 2012 — Poster Session III
10:00 a.m. – Noon	Natcher Conference Center, Building 45	CC	IMAG-28

Authors

• C.T. Sibley
• R.A. Noureldin
• N. Gai
• M.S. Nacif
• S. Liu
• E.B. Turkbey
• J.O. Mudd
• R.J. van der Geest
• J.A.C Lima
• M.K. Halushka
• D.A. Bluemke

Abstract

Purpose: To determine the utility of cardiac MR (CMR) T1 mapping for quantification of diffuse myocardial fibrosis compared to the standard of endomyocardial biopsy. Materials and Methods: We retrospectively identified cardiomyopathy patients who had undergone endomyocardial biopsy (EMB) and CMR at one institution over 5 years. 47 (53% male, mean 46.4 y) had diagnostic CMR and EMB. 13 healthy volunteers (54% male, mean 38.3 y) underwent CMR as a reference. Myocardial T1 mapping was performed 10.7 ± 2.7 minutes after injection of 0.2 mmol/kg gadolinium using an inversion recovery Look-Locker sequence on a 1.5 T scanner. EMB fibrosis was quantified using automated software on digital images of specimens stained with Masson’s trichrome. Results: Median myocardial fibrosis was 8.5% (IQR 5.7, 14.4). T1 times were greater in controls than patients without and patients with evident late gadolinium enhancement (466 ± 14 msec, 406 ± 59 msec and 303 ± 53 msec, respectively, p <0.001). T1 time and histologic fibrosis were inversely correlated (r=-0.57, p<0.0001). The area under the curve (AUC) for myocardial T1 time to detect fibrosis >5% was 0.84. Conclusion: T1 mapping can provide noninvasive evidence of diffuse myocardial fibrosis in patients referred for evaluation of cardiomyopathy.

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