Clinical Applications of Cardiac Magnetic Resonance Parametric Mapping

Figures

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  Figure 1. Example of Construction of a T1-Map. Myocardial T1-mapping using the Modified Look-Locker sequence with increasing inversion times (A). Multiple phases are acquired after an inversion pulse, then the software automatically determines pixel by pixel the signal intensity of each phase-image and subsequently plot it against the inversion time (B). Finally, the T1-time is automatically calculated by performing a curve fitting of the data points to an exponential recovery curve (B: red curve) representing the recovery of longitudinal magnetization. The T1-time is the constant of the exponential curve, represents the time to reach approximately 63% of longitudinal magnetization recovery and is used to generate a color-coded map (C). Reproduced with permission from Muser et al. [3].

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  Figure 2. Native T1-mapping and Extracellular volume fraction in clinical practice. Native T1-mapping and extracellular volume fraction (ECV) have become valuable tools in clinical practice for tissue characterization. Native T1 and ECV offer insights into various pathological processes. However, it is important to acknowledge that the absolute values for native T1 are notably influenced by various factors, including field strength (1.5 T or 3 T), pulse sequence (MOLLI or ShMOLLI), and scanner manufacturer. To maintain clarity and consistency, this figure exclusively incorporates studies conducted using 1.5 T scanners. Figure adapted from Haaf et al. [18].

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  Figure 3. Parametric Mapping in Tako-Tsubo Cardiomyopathy. Case involving a 58-year-old male diagnosed with acute-phase Tako-Tsubo cardiomyopathy, the presentation highlights increase in T2 (panel A) and T1 values (panel B) across the mid and apical regions of the interventricular septum (red arrows).

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  Figure 4. T2 Mapping in Acute Myocarditis. A 31-year-old patient with acute myocarditis affecting the anterolateral left ventricular free wall. Notably, elevated T2 values exceeding 55 ms are evident (Panel A, black arrows) indicative of myocardial edema. Additionally, delayed enhancement is observable in the same area (Panel B, white arrows).

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  Figure 5. T1 Mapping in Cardiac Amyloidosis. A 76-year-old patient diagnosed with transthyretin cardiac amyloidosis. Noteworthy findings encompass severe left ventricular concentric hypertrophy with T1 values surpassing 1100 ms. (Panel A: long axis 4-chamber view and Panel B: mid-ventricular short axis view). Furthermore, global myocardial enhancement is apparent in the LGE (late gadolinium enhancement) images (Panels C,D), displaying intensity akin to that of the blood pool.

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  Figure 6. T1 Mapping in Fabry’s disease. A case involving a 40-year-old female patient with a confirmed diagnosis of Anderson-Fabry disease. Notably, T1 values below 900 ms are evident in the left ventricular free wall (Panels A,B), even in the absence of overt left ventricular hypertrophy (white arrows). This case effectively demonstrates how T1 mapping can serve as a valuable tool for the early detection of cardiac involvement in this condition.