Korean Circ J.  2013 Jan;43(1):1-6. 10.4070/kcj.2013.43.1.1.

Advanced Cardiac MR Imaging for Myocardial Characterization and Quantification: T1 Mapping

• Hwang SH
• Choi BW

• KMID: 1722994
• DOI: http://doi.org/10.4070/kcj.2013.43.1.1

Abstract

Magnetic resonance as an imaging modality provides an excellent soft tissue differentiation, which is an ideal choice for cardiac imaging. Cardiac magnetic resonance (CMR) allows myocardial tissue characterization, as well as comprehensive evaluation of the structures. Although late gadolinium enhancement after injection of the gadolinium extracellular contrast agent has further extended our ability to characterize the myocardial tissue, it also has limitations in the quantification of enhanced myocardial tissue pathology, and the detection of diffuse myocardial disease, which is not easily recognized by enhancement contrast. Recently, the remarkable advances in CMR technique, such as T1 mapping, which can quantitatively evaluate myocardial status, showed potentials to overcome limitations of existing CMR sequences and to expand the application of CMR. This article will review the technical and clinical points to be considered in the practical use of pre- and post-contrast T1 mapping.

Keyword

Magnetic resonance imaging; Myocardium; Gadolinium; Fibrosis; Myocardial infarction

MeSH Terms

Cardiomyopathies
Fibrosis
Gadolinium
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Myocardial Infarction
Myocardium
Gadolinium

Figure

• 

  Fig. 1 Late gadolinium enhancement (LGE) (A), pre- and post-contrast (B and C) T1 map images using 3-T MR system in a patients with prior myocardial infarction in the lateral wall. LGE-MR image shows strong subendocardial enhancement and diffuse wall thinning from chronic infarction in the left anterior descending artery territory of the middle left ventricle level. Post-contrast T1 map image shows a marked T1 shortening in the peri-infarct region, which is not grossly enhanced on LGE image, when compared to the remote zone.

• 

  Fig. 2 Late gadolinium enhancement (LGE) (A), pre- and post-contrast (B and C) T1 map images using 3-T MR system in a patient with secondary myocardial amyloidosis from multiple myeloma. LGE-MR image shows diffuse subendocardial gadolinium enhancement, which is a typical finding of myocardial amyloidosis deposition. Post-contrast T1 map image shows decrease of T1 value in the myocardium which enables quantification of extracellular volume fraction.

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  Fig. 3 Late gadolinium enhancement (LGE) (A), pre- and post-contrast (B and C) T1 map images using 3-T MR system in a patient with esoniophilic myocarditis diagnosed by the biopsy. LGE-MR image shows no remarkable late gadolinium enhancement in the myocardium. Pre-contrast T1 map image shows the prolongation of T1 value in the focal area of mid ventricular septum, compared to the lateral wall. It can suggest the probable edema in the myocardium. Post-contrast T1 mapping show diffusely low T1 value (mean±standard deviation, 410.4±34.4 msec) from gadolinium-induced T1 shortening in the myocardium. Myocardial extracellular volume fraction calculated by the T1 mapping results is 33.5% which is higher than that in normal control in the literature.

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