Abstract 16312: T1-Mapping is Superior to T2-Weighted Cardiovascular Magnetic Resonance Imaging for the Detection of Acute Reversible Myocardial Injury
Background: T2-weighted cardiovascular magnetic resonance (CMR) using short-TI inversion recovery (STIR) is widely used to assess acute myocardial injury, but can be limited by posterior wall signal loss and bright subendocardial signals due to slow-flow blood. T1-mapping is also sensitive to changes in free water content but without these limitations. We hypothesized that T1-mapping using the novel sequence Shortened Modified Look-Locker Inversion Recovery (ShMOLLI) would be more accurate than T2-STIR in detecting acute reversible myocardial injury.
Methods & Results: We studied 14 controls (age 48±14 years) and 14 patients (age 60±13 years) with acute regional myocardial stunning (8 Takotsubo-cardiomyopathy, 6 transient ischemia). CMR within 7 days included cine, ShMOLLI, T2-STIR and late gadolinium enhancement (LGE). Wall motion, absolute T1 values and T2 signal intensity relative to skeletal muscle (T2 SI ratio) were analyzed on a per-subject and segmental basis. No patient had LGE. There was close correlation between mean T1 values and T2 SI ratio (R=0.78). Dysfunctional segments had significantly higher T2 SI ratio (1.98±0.39 vs. 1.52±0.17, p<0.0001) and T1 values (1070±76ms vs. 932±29ms, p<0.0001) than controls. When the ability to detect acute changes in dysfunctional segments was analyzed with receiver operating characteristics, area-under-the-curve was 0.94 for ShMOLLI and 0.86 for T2-STIR (p=0.0005, Figure 1). ShMOLLI T1-mapping had a higher equal sensitivity and specificity point (91% , T1=971ms) than T2-STIR (79%, T2 SI ratio=1.66).
Conclusions: ShMOLLI T1-mapping is superior to T2-STIR in detecting acute reversible myocardial injury at 1.5T.
- © 2011 by American Heart Association, Inc.