T1 and T2 mapping is myocardial biopsy without sampling errors

Late gadolinium enhanced MRI (LGE-MRI) produces positive images of myocardial fibrosis and infarction and is currently the standard imaging technique for evaluation of various cardiomyopathies [ [1] Nagao M. Higashino H. Matsuoka H. et al. Clinical importance of microvascular obstruction on contrast-enhanced MRI in reperfused acute myocardial infarction. Circ. J. 2008; 72: 200-204 Crossref PubMed Scopus (19) Google Scholar ]. Look-Locker sequencing is commonly used in LGE-MRI to visualize prolonged myocardial T1 values outside myocardial cell. This method, which detects the lesion as a relative high signal with normal myocardium as the null point, is excellent for visualization of regional lesions [ [2] Schreiber W.G. Schmitt M. Kalden P. Mohrs O.K. Kreitner K.F. Thelen M. Dynamic contrast-enhanced myocardial perfusion imaging using saturation-prepared true FISP. J. Magn. Reson. Imaging. 2002; 16: 641-652 Crossref PubMed Scopus (102) Google Scholar ]. On the other hand, quantification of lesion size using signal thresholds is not reproducible and is difficult to standardize. The most significant problem is the limitation in the assessment of diffuse myocardial damage. Myocardial T1 and T2 mapping, which calculates tissue-specific T1 and T2 values, has recently become widely used in cardiovascular practice as an imaging method to quantify myocardial injuries including inflammation, edema, and fibrosis. The primary advantage of this technique is that it is a non-invasive objective indicator of diffuse myocardial disorders, such as amyloidosis and myocarditis [ [3] Hinojar R. Foote L. Sangle S. et al. Native T1 and T2 mapping by CMR in lupus myocarditis: disease recognition and response to treatment. Int. J. Cardiol. 2016; : 717-726 Abstract Full Text Full Text PDF PubMed Scopus (69) Google Scholar ]. At the same time, it can complement the limitations of LGE-MRI. Additional value of T1 and T2 mapping techniques for early detection of myocardial involvement in sclerodermaInternational Journal of CardiologyVol. 376PreviewWe evaluated the prevalence of myocardial involvement by native T1 and T2 mapping, the diagnostic performance of mapping in addition to conventional Lake Louise Criteria (LLC), as well as correlations between mapping findings and clinical or conventional cardiovascular magnetic resonance (CMR) parameters in systemic sclerosis (SSc) patients. Full-Text PDF Open Access