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Wang X, Hu Y, Lu X, Cai Y, Shu J. Quantitative T2 mapping of rats with chronic hepatitis. Exp Ther Med 2021; 21:225. [PMID: 33603834 PMCID: PMC7851601 DOI: 10.3892/etm.2021.9656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 12/04/2020] [Indexed: 11/29/2022] Open
Abstract
The aim of the study was to explore the diagnostic value of T2 mapping in an experimental rat model of chronic liver disease. Chronic hepatitis was induced in Sprague-Dawley male rats (n=88) by intraperitoneal and abdominal subcutaneous injection of carbon tetrachloride in olive oil. The normal control rats (n=12) were similarly injected with the same dose of normal saline. All rats were randomly selected and subjected to T2-weighted/spectral adiabatic inversion recovery and multiple gradient- and spin-echo sequence. After scanning, rats were sacrificed immediately and livers removed for staining with hematoxylin and eosin, as well as Masson's trichrome, to determine the pathological stage of hepatic fibrosis, necroinflammatory activity and steatosis. The T2 values were measured and associated with histopathological findings. The T2 values were significantly associated with hepatic fibrosis (P<0.05), but not with hepatitis (P>0.05) or steatosis (P>0.05). By partial correlation analysis, a significant positive correlation was observed between the T2 values and stages of liver fibrosis (r=0.820; P<0.05). T2 values increased with progressive hepatic fibrosis. The differences between T2 values and stages of liver fibrosis were statistically significant. Statistically significant differences were observed between different stages of liver fibrosis (P<0.05), with an area under the curve value of 0.944 for predicting stage F1 or greater, 0.942 for stage F2 or greater, 0.958 for stage F3 or greater, and 0.948 for F4. Thus, the T2 value is one of the quantitative indices of imaging and accurately reflects the stages of liver fibrosis.
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Affiliation(s)
- Xiaofeng Wang
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Yan Hu
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Xin Lu
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Yu Cai
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Jian Shu
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
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Nadjiri J, Zaschka AL, Straeter AS, Sauter A, Englmaier M, Weis F, Laugwitz KL, Rummeny EJ, Pfeiffer D, Rasper M. Evaluation of a shortened cardiac MRI protocol for left ventricular examinations: diagnostic performance of T1-mapping and myocardial function analysis. BMC Med Imaging 2019; 19:57. [PMID: 31340756 PMCID: PMC6657063 DOI: 10.1186/s12880-019-0358-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 07/09/2019] [Indexed: 11/23/2022] Open
Abstract
Background In this study we sought to retrospectively evaluate whether a very brief cardiac magnetic resonance imaging (CMR) protocol sufficiently distinguishes patients with relevant myocardial changes with need for further examination from healthy subjects. Methods Patients with clinical indication for CMR (n = 160) were included in the study. Patients were categorized into two groups depending on presence of left ventricular (LV) dysfunction. ROC-analysis was done for results of T1-, T2- mapping and extracellular volume evaluation in patients without LV dysfunction. Binary endpoint was correctly depicted pathology of the conventional qualitative CMR techniques and report. Results In the patient cohort without LV dysfunction (49%), AUC for T1 mapping was 82% (p < 0.001), 60% for T2 mapping (p = 0.1) and 79% for ECV (p < 0.001). T1 mapping was significantly superior to T2 mapping to rule out left ventricular pathology (p = 0.012). Sensitivity for the combined use of T1 mapping and sBTFE cine imaging was 98%; the negative predictive value was 90%. In 49 patients (30%) full protocol CMR did not provide any additional information; T1 mapping correctly detected 57% of the subjects from this group who would not benefit from additional CMR. Conclusion A shortened CMR protocol comprising T1 mapping and LV-function analysis seems suitable to rule out myocardial alterations. Every third patient of the study population did not benefit from full contrast enhanced CMR. The shortened protocol correctly identified every fifth patient who would not benefit but no relevant pathologic findings with the obligation for treatment were missed.
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Affiliation(s)
- Jonathan Nadjiri
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Anna-Lena Zaschka
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Alexandra S Straeter
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Maximilian Englmaier
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Florian Weis
- Department of Cardiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Karl-Ludwig Laugwitz
- Department of Cardiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Ernst J Rummeny
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Michael Rasper
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
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Krumm P, Mangold S, Gatidis S, Nikolaou K, Nensa F, Bamberg F, la Fougère C. Clinical use of cardiac PET/MRI: current state-of-the-art and potential future applications. Jpn J Radiol 2018. [PMID: 29524169 DOI: 10.1007/s11604-018-0727-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Combined PET/MRI is a novel imaging method integrating the advances of functional and morphological MR imaging with PET applications that include assessment of myocardial viability, perfusion, metabolism of inflammatory tissue and tumors, as well as amyloid deposition imaging. As such, PET/MRI is a promising tool to detect and characterize ischemic and non-ischemic cardiomyopathies. To date, the greatest benefit may be expected for diagnostic evaluation of systemic diseases and cardiac masses that remain unclear in cardiac MRI, as well as for clinical and scientific studies in the setting of ischemic cardiomyopathies. Diagnosis and therapeutic monitoring of cardiac sarcoidosis has the potential of a possible 'killer-application' for combined cardiac PET/MRI. In this article, we review the current evidence and discuss current and potential future applications of cardiac PET/MRI.
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Affiliation(s)
- Patrick Krumm
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
| | - Stefanie Mangold
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Sergios Gatidis
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Felix Nensa
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Fabian Bamberg
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Christian la Fougère
- Department of Radiology, Nuclear Medicine and Clinical Molecular Imaging, University of Tübingen, Tübingen, Germany
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Zhang Y, Xu Y, Wang L, Chen Y, Tian R, Jiao J, Xie H, Yang L, Gao F. Quantitative assessment of salvaged myocardial zone and intramyocardial hemorrhage using non-contrast faster T2 mapping in a rat model by 7T MRI. Exp Ther Med 2017; 14:3425-3432. [PMID: 29042929 PMCID: PMC5639411 DOI: 10.3892/etm.2017.4967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 03/24/2017] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to determine the myocardial area at risk (AAR), infarction-core size (IS) and the salvaged myocardial zone (SMZ), and to evaluate the imaging and histological characteristics of intramyocardial hemorrhage (IMH) after myocardial infarction using non-contrast T2 mapping on 7T magnetic resonance imaging (MRI). Twenty Sprague Dawley (SD) rats were randomly divided into the sham and model groups (n=10 in each). In the model group, myocardial infarction models were established by left anterior descending branch ligation. After 24 h, all animals were imaged on a 7.0 Tesla system with cine spiral imaging, T2 mapping with late gadolinium enhancement (LGE). The rats were then sacrificed for measurement of the IS and AAR using 2,3,5-triphenylterazolium chloride (TTC) and hematoxylin and eosin (H&E) staining. T2 mapping revealed that the AAR in the model group was significantly higher than that in the sham group. No remarkable T2 value was noted in the entire heart of the sham group. LGE and TTC staining demonstrated similar IS. T2 mapping and H&E staining revealed a similar AAR as well. T2 mapping characterized the IMH as a phenomenon resulting from the area of hypointensity in the hyperintensity involving the infarct-core zone and corresponding T2 value 928.6±1.52 msec with IMH vs. 35.8±2.61 msec without IMH; n=3 with 18 slices; P=0.032). In conclusion, non-contrast T2 mapping was a reliable approach to quantitatively evaluate the SMZ and IMH.
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Affiliation(s)
- Yan Zhang
- Department of Radiology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China.,Department of Radiology, General Hospital of PLA, Beijing 100853, P.R. China
| | - Yini Xu
- The Key Laboratory of Optional Utilization of Natural Medicinal Resources, Guizhou Medical University, Huaxi University Town, Guiyang, Guizhou 550025, P.R. China
| | - Lei Wang
- Molecular Imaging Laboratory, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Yushu Chen
- Molecular Imaging Laboratory, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Ruiqing Tian
- Department of Oncology, The First People's Hospital of Guiyang, Guiyang, Guizhou 550002, P.R. China
| | - Jun Jiao
- Department of Radiology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Hong Xie
- Department of Radiology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Li Yang
- Department of Radiology, General Hospital of PLA, Beijing 100853, P.R. China
| | - Fabao Gao
- Molecular Imaging Laboratory, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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Roy C, Slimani A, de Meester C, Amzulescu M, Pasquet A, Vancraeynest D, Vanoverschelde JL, Pouleur AC, Gerber BL. Age and sex corrected normal reference values of T1, T2 T2* and ECV in healthy subjects at 3T CMR. J Cardiovasc Magn Reson 2017; 19:72. [PMID: 28934962 PMCID: PMC5609021 DOI: 10.1186/s12968-017-0371-5] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/10/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Myocardial T1, T2 and T2* imaging techniques become increasingly used in clinical practice. While normal values for T1, T2 and T2* times are well established for 1.5 Tesla (T) cardiovascular magnetic resonance (CMR), data for 3T remain scarce. Therefore we sought to determine normal reference values relative to gender and age and day to day reproducibility for native T1, T2, T2* mapping and extracellular volume (ECV) at 3T in healthy subjects. METHODS After careful exclusion of cardiovascular abnormality, 75 healthy subjects aged 20 to 90 years old (mean 56 ± 19 years, 47% women) underwent left-ventricular T1 (3-(3)-3-(3)-5 MOLLI)), T2 (8 echo- spin echo-imaging) and T2 * (8 echo gradient echo imaging) mapping at 3T CMR (Philips Ingenia 3T and computation of extracellular volume after administration of 0.2 mmol/kg Gadovist). Inter- and intra-observer reproducibility was estimated by intraclass correlation coefficient (ICC). Day to day reproducibility was assessed in 10 other volunteers. RESULTS Mean myocardial T1 at 3T was 1122 ± 57 ms, T2 52 ± 6 ms, T2* 24 ± 5 ms and ECV 26.6 ± 3.2%. T1 (1139 ± 37 vs 1109 ± 73 ms, p < 0.05) and ECV (28 ± 3 vs 25 ± 2%, p < 0.001), but not T2 (53 ± 8 vs 51 ± 4, p = NS) were significantly greater in age matched women than in men. T1 (r = 0.40, p < 0.001) and ECV (r = 0.37, p = 0.001) increased, while T2 decreased significantly (r = -0.25, p < 0.05) with increasing age. T2* was not influenced by either gender or age. Intra and inter-observer reproducibility was high (ICC ranging between 0.81-0.99), and day to day coefficient of variation was low (6.2% for T1, 7% for T2, 11% for T2* and 11.5% for ECV). CONCLUSIONS We provide normal myocardial T2, T2*,T1 and ECV reference values for 3T CMR which are significantly different from those reported at 1.5 Tesla CMR. Myocardial T1 and ECV values are gender and age dependent. Measurement had high inter and intra-observer reproducibility and good day-to-day reproducibility.
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Affiliation(s)
- Clotilde Roy
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - Alisson Slimani
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - Christophe de Meester
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - Mihaela Amzulescu
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - Agnès Pasquet
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - David Vancraeynest
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - Jean-Louis Vanoverschelde
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - Anne-Catherine Pouleur
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
| | - Bernhard L. Gerber
- Pole of Cardiovascular Research (CARD), Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St. Luc, Université Cathologique, Brussels, Belgium
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St., Lambert, Belgium
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Nguyen KL, Hu P, Ennis DB, Shao J, Pham KA, Chen JJ. Cardiac MRI: a Translational Imaging Tool for Characterizing Anthracycline-Induced Myocardial Remodeling. Curr Oncol Rep 2017; 18:48. [PMID: 27292153 DOI: 10.1007/s11912-016-0533-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Cardiovascular side effects of cancer therapeutics are the leading causes of morbidity and mortality in cancer survivors. Anthracyclines (AC) serve as the backbone of many anti-cancer treatment strategies, but dose-dependent myocardial injury limits their use. Cumulative AC exposure can disrupt the dynamic equilibrium of the myocardial microarchitecture while repeated injury and repair leads to myocyte loss, interstitial myocardial fibrosis, and impaired contractility. Although children are assumed to have greater myocardial plasticity, AC exposure at a younger age portends worse prognosis. In older patients, there is lower overall survival once they develop cardiovascular disease. Because aberrations in the myocardial architecture predispose the heart to a decline in function, early detection with sensitive imaging tools is crucial and the implications for resource utilization are substantial. As a comprehensive imaging modality, cardiac magnetic resonance (CMR) imaging is able to go beyond quantification of ejection fraction and myocardial deformation to characterize adaptive microstructural and microvascular changes that are important to myocardial tissue health. Herein, we describe CMR as an established translational imaging tool that can be used clinically to characterize AC-associated myocardial remodeling.
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Affiliation(s)
- Kim-Lien Nguyen
- Diagnostic Cardiovascular Imaging Laboratory, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. .,Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, MC 111E, Los Angeles, CA, 90024, USA.
| | - Peng Hu
- Diagnostic Cardiovascular Imaging Laboratory, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Daniel B Ennis
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Jiaxin Shao
- Diagnostic Cardiovascular Imaging Laboratory, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Kimberly A Pham
- Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, MC 111E, Los Angeles, CA, 90024, USA
| | - Joseph J Chen
- Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, MC 111E, Los Angeles, CA, 90024, USA
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Krumm P, Mueller KAL, Klingel K, Kramer U, Horger MS, Zitzelsberger T, Kandolf R, Gawaz M, Nikolaou K, Klumpp BD, Henes JC. Cardiovascular magnetic resonance patterns of biopsy proven cardiac involvement in systemic sclerosis. J Cardiovasc Magn Reson 2016; 18:70. [PMID: 27765061 PMCID: PMC5073418 DOI: 10.1186/s12968-016-0289-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 09/30/2016] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND To determine morphological and functional cardiovascular magnetic resonance (CMR) patterns in histopathologically confirmed myocardial involvement in patients with systemic sclerosis (SSc). METHODS Twenty patients (6 females; mean age 41 ± 11 years) with histopathologically proven cardiac involvement in SSc in the years 2008-2016 were retrospectively evaluated. Morphological, functional and late gadolinium enhancement (LGE) images were acquired in standard angulations at 1.5 T CMR. Pathologies were categorized: 1) Pericardial effusion; 2) pathologic left (LV) or right ventricular (RV) contractility (hypokinesia, dyssynchrony, and diastolic restriction); 3) reduced left (LV-EF) and right ventricular ejection fraction (RV-EF); 4) fibrosis and/or inflammation (positive LGE); 5) RV dilatation. 95 % confidence intervals (CI) were calculated for appearance of pathologic EF and RV dilatation. RESULTS Seven patients (35 %) had positive CMR findings in three categories, 9 patients (45 %) in four categories and 4 patients (20 %) in five categories. The distribution of pathologic findings was: minimal pericardial effusion in 7 patients (35 %), moderate pericardial effusion >5 mm in nine patients (45 %); abnormal LV or RV contractility in 19 patients (95 %), reduced LV or RV function in 14 patients (70 %; 95 % CI: 51-88 %), pathologic LGE in all patients, RV dilatation in 6 patients (30 %; 95 % CI: 15-54 %). CONCLUSIONS CMR diagnosis of myocardial involvement in SSc requires increased attention to subtle findings. Pathologic findings in at least three of five categories indicate myocardial involvement in SSc.
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MESH Headings
- Adult
- Biopsy
- Cardiomyopathies/diagnostic imaging
- Cardiomyopathies/pathology
- Cardiomyopathies/physiopathology
- Contrast Media/administration & dosage
- Female
- Humans
- Magnetic Resonance Imaging, Cine
- Male
- Middle Aged
- Myocardial Contraction
- Myocardium/pathology
- Organometallic Compounds/administration & dosage
- Pericardial Effusion/diagnostic imaging
- Pericardial Effusion/pathology
- Pericardial Effusion/physiopathology
- Predictive Value of Tests
- Retrospective Studies
- Scleroderma, Systemic/complications
- Scleroderma, Systemic/diagnosis
- Stroke Volume
- Ventricular Dysfunction, Left/diagnostic imaging
- Ventricular Dysfunction, Left/pathology
- Ventricular Dysfunction, Left/physiopathology
- Ventricular Dysfunction, Right/diagnostic imaging
- Ventricular Dysfunction, Right/pathology
- Ventricular Dysfunction, Right/physiopathology
- Ventricular Function, Left
- Ventricular Function, Right
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Affiliation(s)
- Patrick Krumm
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, Tübingen, 72076 Germany
| | - Karin A. L. Mueller
- Department of Internal Medicine III, Cardiology and Cardiovascular Medicine, University of Tübingen, Tübingen, Germany
| | - Karin Klingel
- Department of Pathology and Neuropathology, Molecular Pathology, University of Tübingen, Tübingen, Germany
| | - Ulrich Kramer
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, Tübingen, 72076 Germany
| | - Marius S. Horger
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, Tübingen, 72076 Germany
| | - Tanja Zitzelsberger
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, Tübingen, 72076 Germany
| | - Reinhard Kandolf
- Department of Pathology and Neuropathology, Molecular Pathology, University of Tübingen, Tübingen, Germany
| | - Meinrad Gawaz
- Department of Internal Medicine III, Cardiology and Cardiovascular Medicine, University of Tübingen, Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, Tübingen, 72076 Germany
| | - Bernhard D. Klumpp
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, Tübingen, 72076 Germany
| | - Joerg C. Henes
- Department of Internal Medicine II, Rheumatology, University of Tübingen, Tübingen, Germany
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8
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Gao X, Liu M, Qu A, Chen Z, Jia Y, Yang N, Feng X, Liu J, Xu Y, Yang X, Wang G. Native Magnetic Resonance T1-Mapping Identifies Diffuse Myocardial Injury in Hypothyroidism. PLoS One 2016; 11:e0151266. [PMID: 26964099 PMCID: PMC4786209 DOI: 10.1371/journal.pone.0151266] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 02/25/2016] [Indexed: 12/11/2022] Open
Abstract
Background and Aim Hypothyroidism (HT) is characterized by thyroid hormone deficiencies, which can lead to diffuse myocardial interstitium lesions in patients with HT. Myocardial longitudinal relaxation time (T1) mapping is a potential diagnostic tool for quantifying diffuse myocardial injury. This study aimed to assess the usefulness of T1 mapping in identifying myocardial involvement in HT, and determine the relationship between T1 values and myocardial function. Methods A cross-sectional study was conducted with 30 untreated HT patients alongside 23 age- and sex-matched healthy controls. All subjects underwent cardiac magnetic resonance (CMR) with non-contrast (native) T1 mapping using a modified Look-Locker inversion-recovery (MOLLI) sequence to assess the native T1 values of myocardium and cardiac function. Results Native myocardial T1 values were significantly increased in HT patients, especially those with pericardial effusion (p < 0.05), compared with healthy controls. In addition, significantly reduced peak filling rate (PFR) and prolonged peak filling time (PFT) were obtained (p < 0.05) in HT patients compared with controls. Furthermore, stroke volume (SV) and cardiac index (CI) were significantly lower in HT patients than controls (all p < 0.05). Interestingly, native T1 values were negatively correlated with free triiodothyronine (FT3), PFR, SV and CI (all p < 0.05). Conclusion Diffuse myocardial injuries are common in HT patients, and increased T1 values are correlated with FT3 and cardiac function impairment. These findings indicate that T1 mapping might be useful in evaluating myocardial injuries in HT patients.
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Affiliation(s)
- Xia Gao
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Min Liu
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Aijuan Qu
- Department of Physiology and Pathophysiology, School of Basic Medical Science, Capital Medical University, Beijing, People's Republic of China
| | - Zhe Chen
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yumei Jia
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Ning Yang
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xiaomeng Feng
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jia Liu
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yuan Xu
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xinchun Yang
- Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
- * E-mail: (XY); (GW)
| | - Guang Wang
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
- * E-mail: (XY); (GW)
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9
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Sprinkart AM, Luetkens JA, Träber F, Doerner J, Gieseke J, Schnackenburg B, Schmitz G, Thomas D, Homsi R, Block W, Schild H, Naehle CP. Gradient Spin Echo (GraSE) imaging for fast myocardial T2 mapping. J Cardiovasc Magn Reson 2015; 17:12. [PMID: 25885268 PMCID: PMC4326516 DOI: 10.1186/s12968-015-0127-z] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 01/26/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Quantitative Cardiovascular Magnetic Resonance (CMR) techniques have gained high interest in CMR research. Myocardial T2 mapping is thought to be helpful in diagnosis of acute myocardial conditions associated with myocardial edema. In this study we aimed to establish a technique for myocardial T2 mapping based on gradient-spin-echo (GraSE) imaging. METHODS The local ethics committee approved this prospective study. Written informed consent was obtained from all subjects prior to CMR. A modified GraSE sequence allowing for myocardial T2 mapping in a single breath-hold per slice using ECG-triggered acquisition of a black blood multi-echo series was developed at 1.5 Tesla. Myocardial T2 relaxation time (T2-RT) was determined by maximum likelihood estimation from magnitude phased-array multi-echo data. Four GraSE sequence variants with varying number of acquired echoes and resolution were evaluated in-vitro and in 20 healthy volunteers. Inter-study reproducibility was assessed in a subset of five volunteers. The sequence with the best overall performance was further evaluated by assessment of intra- and inter-observer agreement in all volunteers, and then implemented into the clinical CMR protocol of five patients with acute myocardial injury (myocarditis, takotsubo cardiomyopathy and myocardial infarction). RESULTS In-vitro studies revealed the need for well defined sequence settings to obtain accurate T2-RT measurements with GraSE. An optimized 6-echo GraSE sequence yielded an excellent agreement with the gold standard Carr-Purcell-Meiboom-Gill sequence. Global myocardial T2 relaxation times in healthy volunteers was 52.2 ± 2.0 ms (mean ± standard deviation). Mean difference between repeated examinations (n = 5) was -0.02 ms with 95% limits of agreement (LoA) of [-4.7; 4.7] ms. Intra-reader and inter-reader agreement was excellent with mean differences of -0.1 ms, 95% LoA = [-1.3; 1.2] ms and 0.1 ms, 95% LoA = [-1.5; 1.6] ms, respectively (n = 20). In patients with acute myocardial injury global myocardial T2-RTs were prolonged (mean: 61.3 ± 6.7 ms). CONCLUSION Using an optimized GraSE sequence CMR allows for robust, reliable, fast myocardial T2 mapping and quantitative tissue characterization. Clinically, the GraSE-based T2-mapping has the potential to complement qualitative CMR in patients with acute myocardial injuries.
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Affiliation(s)
- Alois M Sprinkart
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
- Institute of Medical Engineering, Ruhr-University Bochum, Universitätsstraße, Bochum, Germany.
| | - Julian A Luetkens
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
| | - Frank Träber
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
| | - Jonas Doerner
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
| | - Jürgen Gieseke
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
- Philips Healthcare Germany, Lübeckertordamm, Hamburg, Germany.
| | | | - Georg Schmitz
- Institute of Medical Engineering, Ruhr-University Bochum, Universitätsstraße, Bochum, Germany.
| | - Daniel Thomas
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
| | - Rami Homsi
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
| | - Wolfgang Block
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
| | - Hans Schild
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
| | - Claas P Naehle
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
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10
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Langhans B, Nadjiri J, Jähnichen C, Kastrati A, Martinoff S, Hadamitzky M. Reproducibility of area at risk assessment in acute myocardial infarction by T1- and T2-mapping sequences in cardiac magnetic resonance imaging in comparison to Tc99m-sestamibi SPECT. Int J Cardiovasc Imaging 2014; 30:1357-63. [PMID: 24984612 DOI: 10.1007/s10554-014-0467-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 06/07/2014] [Indexed: 11/29/2022]
Abstract
Area at risk (AAR) is an important parameter for the assessment of the salvage area after revascularization in acute myocardial infarction (AMI). By combining AAR assessment by T2-weighted imaging and scar quantification by late gadolinium enhancement imaging cardiovascular magnetic resonance (CMR) offers a promising alternative to the "classical" modality of Tc99m-sestamibi single photon emission tomography (SPECT). Current T2 weighted sequences for edema imaging in CMR are limited by low contrast to noise ratios and motion artifacts. During the last years novel CMR imaging techniques for quantification of acute myocardial injury, particularly the T1-mapping and T2-mapping, have attracted rising attention. But no direct comparison between the different sequences in the setting of AMI or a validation against SPECT has been reported so far. We analyzed 14 patients undergoing primary coronary revascularization in AMI in whom both a pre-intervention Tc99m-sestamibi-SPECT and CMR imaging at a median of 3.4 (interquartile range 3.3-3.6) days after the acute event were performed. Size of AAR was measured by three different non-contrast CMR techniques on corresponding short axis slices: T2-weighted, fat-suppressed turbospin echo sequence (TSE), T2-mapping from T2-prepared balanced steady state free precession sequences (T2-MAP) and T1-mapping from modified look locker inversion recovery (MOLLI) sequences. For each CMR sequence, the AAR was quantified by appropriate methods (absolute values for mapping sequences, comparison with remote myocardium for other sequences) and correlated with Tc99m-sestamibi-SPECT. All measurements were performed on a 1.5 Tesla scanner. The size of the AAR assessed by CMR was 28.7 ± 20.9 % of left ventricular myocardial volume (%LV) for TSE, 45.8 ± 16.6 %LV for T2-MAP, and 40.1 ± 14.4 %LV for MOLLI. AAR assessed by SPECT measured 41.6 ± 20.7 %LV. Correlation analysis revealed best correlation with SPECT for T2-MAP at a T2-threshold of 60 ms (ms) (slope = 0.99, Pearson's r = 0.94), and for MOLLI at T1-threshold of 1,075 ms (slope 0.86, r = 0.91, Pearson's r = 0.45). For the assessment of AAR in AMI, the novel T2-mapping technique correlates best with SPECT size, T1-mapping with MOLLI and standard T2-weighted imaging showed similar good correlations.
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Affiliation(s)
- Birgit Langhans
- Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany
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