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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Comparison of quantitative imaging parameters using cardiovascular magnetic resonance between cardiac amyloidosis and

Bo Da Nam1,2, Sung Mok Kim3,4,5, Hye Na Jung1,6

  • 1Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

The International Journal of Cardiovascular Imaging
|May 31, 2018
PubMed

Insights

The inversion time (TI) interval is a feasible cardiac MRI parameter for differentiating cardiac amyloidosis (CA) from hypertrophic cardiomyopathy (HCMP), performing comparably to extracellular volume (ECV) when T1 mapping is unavailable.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Cardiomyopathy Research

Background:

  • Cardiac amyloidosis (CA) and hypertrophic cardiomyopathy (HCMP) are distinct conditions requiring accurate differentiation.
  • Cardiac magnetic resonance (CMR) imaging offers quantitative parameters for diagnosing cardiomyopathies.
  • Distinguishing CA from HCMP is crucial for appropriate patient management and treatment.

Purpose of the Study:

  • To compare inversion time (TI) parameters, native T1, and extracellular volume (ECV) using CMR between patients with CA and HCMP.
  • To evaluate the diagnostic performance of TI interval compared to native T1 and ECV in differentiating CA from HCMP.
  • To assess the feasibility of TI interval as a quantitative CMR parameter when T1 mapping is not available.

Main Methods:

  • Retrospective analysis of CMR data from 46 patients with biopsy-confirmed CA and 30 patients with HCMP.
  • Measurement of T1 and TI values in the left ventricle septum and cavity using T1 mapping and TI scout images.
  • Selection of TI values at the nulling point for myocardium and blood pool to calculate TI interval.

Main Results:

  • Significant differences in native T1, ECV, and TI interval values were observed between CA and HCMP groups (all p < 0.001).
  • The diagnostic performance of TI interval (AUC, 0.975) was comparable to ECV (AUC, 0.980) and superior to native T1 (AUC, 0.845).
  • TI interval demonstrated high accuracy in differentiating CA from HCMP.

Conclusions:

  • The TI interval is a valuable and feasible quantitative CMR parameter for the differential diagnosis between CA and HCMP.
  • TI interval performance is comparable to ECV, offering a viable alternative when T1 mapping is not available.
  • This finding aids in improving diagnostic accuracy for cardiomyopathies using standard CMR sequences.

Keywords:
AmyloidosisCardiovascular magnetic resonanceExtracellular volumeHypertrophic cardiomyopathyInversion time

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