Assessing Acute Pericarditis with T1 Mapping: A Supportive Contrast-Free CMR Marker

Area of Science:

• Cardiovascular Magnetic Resonance (CMR) Imaging
• Cardiac Imaging Biomarkers
• Pericardial Disease Diagnosis

Background:

• Acute pericarditis diagnosis often relies on clinical criteria and imaging.
• Non-contrast cardiovascular magnetic resonance (CMR) techniques are desirable for patient safety and accessibility.
• Pericardial T1 mapping offers a quantitative assessment of myocardial and pericardial tissue properties.

Purpose of the Study:

• To evaluate pericardial T1 mapping as a non-contrast supportive parameter for diagnosing acute pericarditis.
• To investigate the association between pericardial T1 values and clinical/biomarker data in acute pericarditis.
• To compare pericardial T1 mapping values between patients with acute pericarditis and healthy controls.

Main Methods:

• Retrospective analysis of CMR scans from 35 acute pericarditis patients and 17 matched healthy controls.
• Measurement of pericardial T1 mapping values, encompassing effusion and layer thickness.
• Comparison of pericardial T1 values between patient and control groups, with multivariable and ROC curve analyses.

Main Results:

• Acute pericarditis patients exhibited significantly lower pericardial T1 mapping values (2137 ± 519 ms) compared to controls (3268 ± 362 ms) (p=0.001).
• Pericardial T1 mapping values were independently associated with the severity of pericardial late gadolinium enhancement (LGE) (β = -3.271, p=0.003).
• Receiver operating characteristic analysis demonstrated excellent diagnostic performance for pericardial T1 mapping in discriminating acute pericarditis (AUC=0.97).

Conclusions:

• Pericardial T1 mapping serves as a valuable non-contrast CMR parameter for identifying acute pericarditis.
• The technique shows an independent association with the severity of pericardial LGE.
• Non-contrast pericardial T1 mapping can enhance diagnostic capabilities for acute pericarditis.