Parametric mapping CMR showed elevated pericardial T1 (1363.0 vs 998.7 ms) and T2 (123.3 vs 68.0 ms) values compared to myocardium in patients with pericardial inflammation (p<0.001).
Observational (n=24)
Does parametric mapping CMR (T1/T2 mapping) identify elevated T1 and T2 values in patients with pericardial inflammation compared to myocardium and chronic pericarditis?
Parametric mapping CMR shows elevated T1 and T2 values in pericardial inflammation, which may facilitate diagnosis when conventional imaging is heterogeneous.
p-value: p=<0.001
OBJECTIVES: Although cardiovascular magnetic resonance (CMR) is increasingly used to diagnose pericardial inflammation, imaging can still be challenging using conventional CMR techniques. Parametric mapping (T1/T2 mapping) techniques have emerged as novel methods to quantify focal and global changes of the myocardium without contrast agent. The aim of the present study was to implement parametric mapping to facilitate diagnostic decision-making in pericardial inflammation. METHODS: Twenty patients with pericardial inflammation underwent CMR (1.5T system) including T1-weighted/T2-weighted imaging, T1/T2 mapping and late gadolinium enhancement. T1/T2 mapping was performed in end-diastole covering three short-axis slices. Diagnosis of pericardial inflammation was made according to recent guidelines. T1/T2 measurements were pursued by manually drawing regions of interest (ROIs) in the thickened, diseased pericardium carefully avoiding contamination by other cardiac structures. Parametric values were correlated to further markers of pericardial inflammation, such as pericardial thickening and inflammatory parameters. RESULTS: On average, the pericardium displayed a thickness of 4.8±1.0 mm. Mean T1 value was 1363.0±227.1 ms and T2 value was 123.3±52.6 ms, which were above patient's myocardial values (myocardial T1: 998.7±81.0 ms, p<0.001, median 1014.46 ms; T2: 68.0±28.9 m,p<0.001) and the values of a group of four patients with chronic pericarditis (T1: 953.0±16.7 ms; T2: 63.2±10.1 ms). T1 and T2 showed a correlation to the extent of the thickened pericardium (R=0.64, p=0.002 for T1, R=0.72, p=0.005 for T2). There was no correlation of pericardial T1/T2 to blood markers of inflammation, myocardial injury (C reactive protein, troponin, creatine kinase) or further CMR parameters. CONCLUSIONS: In patients with pericardial inflammation, parametric mapping showed elevated T1 and T2 values. Parametric mapping may help to facilitate diagnosis of pericardial inflammation if conventional parameters such as pericardial hyperintensity in T1-weighted or T2-weighted imaging or contrast agent uptake are heterogeneous.
Gastl et al. (Sun,) conducted a observational in Pericardial inflammation (n=24). Parametric mapping CMR (T1/T2 mapping) vs. Myocardium and chronic pericarditis was evaluated on T1 and T2 mapping values of the pericardium (p=<0.001). Parametric mapping CMR showed elevated pericardial T1 (1363.0 vs 998.7 ms) and T2 (123.3 vs 68.0 ms) values compared to myocardium in patients with pericardial inflammation (p<0.001).