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Myocardial T1 Mapping for Detection of Left Ventricular Myocardial Fibrosis in Chronic Aortic Regurgitation: Pilot Study

Patrick Sparrow1, Daniel R. Messroghli2, Scott Reid3, John P. Ridgway3, Gavin Bainbridge1 and Mohan U. Sivananthan1

1 Department of Radiology, British Heart Foundation Cardiac MRI Unit, General Infirmary at Leeds, Great George St., Rm. 170, D Fl., Jubilee Wing, Leeds LS1 3EX, UK.
2 Cardiac MRI Unit, Franz-Volhard-Klinik, Charité/Humboldt University, Berlin, Germany.
3 Department of Medical Physics, University of Leeds, Leeds, UK.


Figure 1
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  		Fig. 1A —59-year-old woman (subject 6) with 12-month history of aortic regurgitation secondary to idiopathic aortic root dilatation. Short-axis parametric T1 maps acquired before (A) and 10 minutes after administration of gadolinium (B). Green and red lines represent epicardial and endocardial contours manually drawn for delineation of left ventricular myocardium. Pixel signal intensity is determined by individual pixel T1 relaxation times, hence darker image after gadolinium administration.

 

Figure 2
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  		Fig. 1B —59-year-old woman (subject 6) with 12-month history of aortic regurgitation secondary to idiopathic aortic root dilatation. Short-axis parametric T1 maps acquired before (A) and 10 minutes after administration of gadolinium (B). Green and red lines represent epicardial and endocardial contours manually drawn for delineation of left ventricular myocardium. Pixel signal intensity is determined by individual pixel T1 relaxation times, hence darker image after gadolinium administration.

 

Figure 3
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  		Fig. 2 —43-year-old man (subject 4) with 6-month history of aortic regurgitation secondary to idiopathic aortic root dilatation. ECG-gated breath-hold short-axis T1-weighted inversion recovery spoiled gradient-echo delayed enhancement image (TR/TE, 4.7/2; flip angle, 15°) shows focal area of delayed enhancement in mid lateral wall of left ventricle (arrow) suggestive of focal fibrosis.

 

Figure 4
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  		Fig. 3 —60-year-old man (subject 5) with 4-year history of aortic regurgitation of unknown cause. ECG-gated breath-hold short-axis T1-weighted inversion recovery spoiled gradient-echo delayed enhancement image (TR/TE, 4.6/1.8; flip angle, 15°) shows focal area of delayed enhancement in lateral wall of left ventricle (arrow) suggestive of focal fibrosis.

 

Figure 5
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  		Fig. 4 —Graph shows mean myocardial T1 relaxation time for each acquisition before and after gadolinium administration in group with aortic regurgitation (white) and control group of healthy persons (gray). Error bars represent 1 SD.

 

Figure 6
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  		Fig. 5 —Graph shows mean myocardial T1 relaxation time in segments with abnormal wall motion in aortic regurgitation group (open boxes) compared with healthy controls (solid boxes). Asterisks denote statistically significant difference (p < 0.05). Error bars for control group = 2 SD. Pre-Gd = before administration of gadolinium.

 

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