Myocardial fibrosis evaluated by diffusion-weighted imaging and its relationship to 3D contractile function in

Rui Wu1, Dong-Aolei An1, Ruo-Yang Shi1

  • 1Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Abstract

Insights

Apparent diffusion coefficient (ADC) effectively detects myocardial fibrosis in hypertrophic cardiomyopathy (HCM). ADC correlates with extracellular volume and contractile function, offering a viable alternative to LGE and ECV for fibrosis assessment.

Area of Science:

  • Cardiovascular Imaging
  • Biomedical Engineering
  • Radiology

Background:

  • Diffusion-weighted imaging (DWI) demonstrates sensitivity to myocardial fibrosis in various cardiomyopathies.
  • Hypertrophic cardiomyopathy (HCM) is characterized by myocardial fibrosis and impaired contractile function.

Purpose of the Study:

  • To investigate the prognostic value of apparent diffusion coefficient (ADC) in detecting myocardial fibrosis within HCM.
  • To explore the relationship between ADC, myocardial fibrosis, and contractile function in HCM patients.

Main Methods:

  • A prospective study involving 45 HCM patients and 20 controls using 3.0T cardiac MRI.
  • Cardiac MR sequences included cine, T1 mapping, and DWI.
  • Assessment of ADC values for myocardial fibrosis detection and correlation with extracellular volume (ECV) and late gadolinium enhancement (LGE).

Main Results:

  • ADC values were significantly increased in patients with higher ECV and LGE, indicating greater fibrosis.
  • ADC showed a strong linear association with ECV (R²=0.65).
  • ADC values correlated significantly with impaired circumferential and longitudinal strain and strain rates.

Conclusions:

  • Apparent diffusion coefficient (ADC) is a feasible and effective tool for detecting myocardial fibrosis in HCM.
  • ADC serves as a valuable alternative to ECV and LGE for assessing fibrosis and its impact on contractile dysfunction in HCM.

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