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Conventional T2 assessment of myocardial edema evaluates the ratio of myocardial to skeletal signal intensity on T2-weighted short-TI inversion recovery (STIR) images but is prone to image-quality issues. Novel T2-mapping sequences have been developed that may facilitate accurate and reproducible direct quantification of myocardial T2, however limited data are available beyond highly selected series. We compared feasibility of novel T2-mapping with conventional T2 STIR in routine clinical practice.
T2-mapping was performed using a multi-echo double-IR FSE (MEFSE) sequence (GE Medical) in 53 consecutive patients (age 42±16yrs, 59% male) scheduled for routine inflammation-protocol cardiac MRI and compared with conventional STIR.
Non-contrast T2-mapping was feasible in 96% with average T2 51.7±9.8ms. Image quality was excellent in 55% (T2=51.3±9.4), good in 23% (T2=51.2±6.4ms), poor in 19% (T2=53.2±14.3). STIR image quality was poor in 15%, good in 77%, excellent in 4%. Quantitative T2 correlated with STIR ratio (r=0.3, P=0.036) and relative gadolinium enhancement ratio (RER) (r=0.4, p=0.002). STIR did not correlate with RER (p=0.3). Patients with elevated RER (≥4.0, consistent with inflammation) had higher T2 (57.2±13.4 vs 49.4±6.9ms, p=0.008), whereas an abnormal STIR ratio (≥2.0) was not associated with higher T2 (52.1±9.0 vs 50.1±12.8, p=0.5). In a multivariate model including gender, age, HR, LVEF, STIR and RER, age (p=0.025) and RER (p=0.002) were the only significant predictors of quantitative T2.
Myocardial T2-mapping is feasible in routine clinical practice and is more strongly associated with RER than conventional MRI edema assessment. T2-mapping may allow more robust assessment of myocardial inflammation.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Imaging: MRI VI – Clinical Applications and Advances in CMR
Abstract Category: 19. Imaging: MRI
Presentation Number: 1310-313
- 2013 American College of Cardiology Foundation