Multiparametric Mapping
Ersin Cavus, MD
Resident Doctor
University Medical Center Hamburg-Eppendorf
Hamburg, Hamburg, Germany
Ersin Cavus, MD
Resident Doctor
University Medical Center Hamburg-Eppendorf
Hamburg, Hamburg, Germany
Jan Schneider, MD
Resident Doctor
University Medical Center Hamburg-Eppendorf, Germany
Eleonora di Carluccio, MSc
Statistician
Cardio-CARE Davos, Germany
Andreas Ziegler
Statistician
Cardio-CARE Davos, Germany
Celeste Chevalier
MD
University Heart and Vascular Center Hamburg Eppendorf, Germany
Charlotte M. Jahnke, MD
Medical Resident
University Medical Center Hamburg-Eppendorf, Germany
Katharina Alina Riedl
MD
University Heart and Vascular Center Hamburg Eppendorf, Germany
Enver G. Tahir, MD
Senior physician
University Medical Center Hamburg-Eppendorf
Hamburg, Hamburg, Germany
Gerhard Adam, MD
Director of the Radiology Department
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Paulus Kirchhof
Co-Director of the Cardiology Department
University Heart and Vascular Center Hamburg Eppendorf, Germany
Raphael Twerenbold
MD
University Heart and Vascular Center Hamburg Eppendorf, Germany
Stefan Blankenberg, MD
Director of the Cardiology Department
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Gunnar K. Lund, MD
MD
University Medical Center Hamburg-Eppendorf, Department of Radiology, Hamburg, Germany
Kai Muellerleile, MD
Senior Physician
University Medical Center Hamburg-Eppendorf, Germany
Multiparametric cardiovascular magnetic resonance imaging (CMR) enables a comprehensive assessment of different myocardial tissue alterations by measurements of native and postcontrast T1, quantification of extracellular volume (ECV) and T2. However, several potential influencing factors such as field strength, imaging sequences and sex need to be considered for clinical application of the obtained measurements. In this study, we describe the regional distribution of T1, ECV and T2 according to the 16-segment model in the population-based Hamburg City Health Study (HCHS) CMR sample.
Methods:
From the first 10.000 consecutive participants of the German HCHS (46-78 years of age), 2589 CMR data were available. After excluding 1013 participants with prevalent heart disease, any kind of LGE or missing data, the final study sample consisted of 1576 participants with 3T CMR (MAGNETOM Skyra, Siemens Healthcare, Erlangen, Germany). Contrast enhanced CMR (0.15mmol/kg gadorate meglumine [Dotarem, Guerbet, Aulnay, France]) was available in 619 (39%) participants. T1 and T2 were assessed on basal, mid-ventricular and apical short-axis slices at end-diastole and were assigned to the 16-segment model. Pre- and postcontrast T1 were performed using modified Look-Locker inversion recovery (MOLLI) sequences with a 5b(3b)3b (native) and 4b(1b)3b(1b)2b (postcontrast) scheme, respectively. T2 mapping was performed by a T2-prepared single-shot fast-low-angle shot sequence. Image analyses were performed using cvi42 (Circle Cardiovascular Imaging Inc., Calgary Canada). Continuous data are presented as median and inter-quartile-range [IQR].
Results:
Regional distributions of T1, ECV and T2 according the 16-segment model are provided by Figure 1. The highest median native T1 values were observed in the inferior, basal segment 4 (1194 [IQR, 1168-1221] ms) and the septal, apical segment 14 (1194 [1168-1224] ms), whereas the lowest median native T1 was found in the anterior, midventricular segment 7 (1152 [1123-1177] ms, p< 0.001 for segment 4 and 14 when compared with segment 7, repectively). Median postcontrast values were highest in the anterior, basal segment 1 (613 [577-648] ms) and lowest in the inferior, basal segment 4 (597 [562-635] ms (p< 0.001 compared with segment 1). Corresponding to the distribution of native T1, median ECV was highest in segment 4 (28 [26-30] %) and 14 (28 [26-30] %). Median T2 was highest in the apical segments 13, 14 and 16 (40 [38-42] ms) and in the septal, midventricular segment 8.
Conclusion:
Regional distribution needs to be considered as an adjunct factor for clinical interpretation of T1, ECV and T2, even in the absence of apparent heart disease. In particular, clinicians should be aware of higher native T1 and ECV values in the inferior, basal LV region and higher T2 values in the apex.