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Variability and homogeneity of cardiovascular magnetic resonance myocardial T2-mapping in volunteers compared to patients with edema

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Item Type:Article
Title:Variability and homogeneity of cardiovascular magnetic resonance myocardial T2-mapping in volunteers compared to patients with edema
Creators Name:Wassmuth, R and Prothmann, M and Utz, W and Dieringer, M. and von Knobelsdorff-Brenkenhoff, F. and Greiser, A and Schulz-Menger, J.
Abstract:BACKGROUND: The aim of the study was to test the reproducibility and variability of myocardial T2 mapping in relation to sequence type and spatial orientation in a large group of healthy volunteers. For control T2 mapping was also applied in patients with true edema. Cardiovascular magnetic resonance (CMR) T2-mapping has potential for the detection and quantification of myocardial edema. Clinical experience is limited so far. The variability and potential pitfalls in broad application are unknown. METHODS: Healthy volunteers (n = 73, 35 +/- 13 years) and patients with edema (n = 28, 55 +/- 17 years) underwent CMR at 1.5 T. Steady state free precession (SSFP) cine loops and T2-weighted spin echo images were obtained. In patients, additionally late gadolinium enhancement images were acquired. We obtained T2 maps in midventricular short axis (SAX) and four-chamber view (4CV) based on images with T2 preparation times of 0, 24, 55 ms and compared fast low angle shot (FLASH) and SSFP readout. 10 volunteers were scanned twice on separate days. Two observers analysed segmental and global T2 per slice. RESULTS: In volunteers global myocardial T2 systematically differed depending on image orientation and sequence (FLASH 52 +/- 5 vs. SSFP 55 +/- 5 ms in SAX and 57 +/- 6 vs. 59 +/- 6 ms in 4CV; p < 0.0001 for both). Anteroseptal and apical segments had higher T2 than inferior and basal segments (SAX: 59 +/- 6 vs. 48 +/- 5 ms for FLASH and 59 +/- 7 vs. 52 +/- 4 ms for SSFP; p < 0.0001 for both). 14 volunteers had segments with T2 >/= 70 ms. Mean intraobserver variability was 1.07 +/- 1.03 ms (r = 0.94); interobserver variability was 1.6 +/- 1.5 ms (r = 0.87). The coefficient of variation for repeated scans was 7.6% for SAX and 6.6% for 4CV. Mapping revealed focally increased T2 (73 +/- 9 vs. 51 +/- 3 ms in remote myocardium; p < 0.0001) in all patients with edema. CONCLUSIONS: Myocardial T2 mapping is technically feasible and highly reproducible. It can detect focal edema und differentiate it from normal myocardium. Increased T2 was found in some volunteers most likely due to partial volume and residual motion.
Keywords:Artifacts, Cardiac Edema, Case-Control Studies, Cine Magnetic Resonance Imaging, Contrast Media, Feasibility Studies, Gadolinium DTPA/diagnostic use, Imaging Phantoms, Myocardium, Observer Variation, Predictive Value of Tests, Reproducibility of Results
Source:Journal of Cardiovascular Magnetic Resonance
Publisher:BioMed Central
Page Range:27
Date:27 March 2013
Official Publication:https://doi.org/10.1186/1532-429X-15-27
PubMed:View item in PubMed

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