Histological validation of ShMOLLI equilibrium contrast CMR for the measurement of diffuse myocardial fibrosis
Key result
ShMOLLI CMR volume of distribution yields a strong ~0.75 correlation with histological collagen volume fraction.
- r=0.748
- P=0.007
- n=14
Why the study?
Does ShMOLLI equilibrium contrast CMR accurately measure diffuse myocardial fibrosis compared to histology in patients with severe aortic stenosis?
Population
14 patients with symptomatic severe aortic stenosis awaiting valve surgery
Comparison
ShMOLLI and standard multibreathold mapping for… vs Surgical left ventricular septal biopsy
Design
Cross-sectional, Collagen volume fraction was calculated by a blinded observer
Authors
Discussion
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Member takes
Implication
Should not yet change practice in severe AS; supports non-invasive fibrosis quantification but leaves open outcome prediction and therapeutic guidance.
Study Design
Type
Cross-Sectional (n=14)
Blinding
Single-blind
Structured PICO
Does ShMOLLI equilibrium contrast CMR accurately measure diffuse myocardial fibrosis compared to histology in patients with severe aortic stenosis?
P
Population
14 patients with symptomatic severe aortic stenosis awaiting valve surgery who underwent equilibrium contrast CMR and surgical biopsy.
E
Exposure
ShMOLLI (Shortened Modified Look-Locker Inversion recovery) and standard multibreathold (FLASH) mapping for pre and equilibrium contrast T1 mapping (EQ-CMR)
C
Comparator
Surgical left ventricular septal biopsy (histological validation)
O
Outcome
Correlation between MRI measured myocardial volume of distribution Vd(m) and histological collagen volume fraction (CVF%)surrogate
Main Result
Effect estimate: r=0.748
p-value: p=0.007
Rapid T1 mapping with ShMOLLI can accurately measure myocardial volume of distribution and correlates well with histological fibrosis, offering a faster alternative to multibreathold mapping techniques.
Limitations
- Small sample size (n=14)
- FLASH T1 mapping was not possible in 2 out of 14 patients due to inability to breath hold and persistent ectopy
- 2 biopsy specimens were excluded because they were thought histologically to be superficial with extremes of fibrosis
Cite This Study
White et al. (2012) conducted a cross-sectional in Symptomatic severe aortic stenosis (n=14). ShMOLLI equilibrium contrast CMR vs. Histological collagen volume fraction (CVF%) from surgical biopsy was evaluated on Correlation between histological CVF% and ShMOLLI Vd(m) (r=0.748, p=0.007). ShMOLLI equilibrium contrast CMR measurements of myocardial volume of distribution strongly correlated with histological collagen volume fraction (r=0.748, p=0.007).