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Abstract
Diffuse interstitial myocardial fibrosis has been described in various cardiac pathologies. Late gadolinium enhancement by cardiac magnetic resonance can detect the presence of focal myocardial fibrosis, but is limited for the assessment of diffuse interstitial fibrosis. T1 myocardial mapping is a noninvasive imaging technique which enables visualization and quantification of diffuse interstitial myocardial fibrosis. In this article, we review the T1 mapping technique and its utility in various cardiovascular disorders associated with presence of diffuse interstitial fibrosis.
Highlights
The Extracellular Matrix (ECM) in a normal human heart is composed of collagen fibers, proteoglycans, glycosaminoglycans and fibroblasts
Replacement myocardial fibrosis corresponds to the replacement of myocytes due to cardiomyocyte necrosis and apoptosis resulting from underlying pathologies including ischemia, infarction, and myocarditis
Infiltrative myocardial fibrosis is seen in conditions like Amyloidosis, Anderson-Fabry disease
Summary
The Extracellular Matrix (ECM) in a normal human heart is composed of collagen fibers, proteoglycans, glycosaminoglycans and fibroblasts. A heart rate correction of these obtained T1 values as described by Messroghli et al should increase the sensitivity and specificity of this technique for assessment of myocardial fibrosis [11] To overcome this limitation of heart rate correction, an optimized MOLLI sequence was described by Messroghli et al [12]. Myocardial post contrast T1 values are affected by a variety of technical and physiological factors including the type and amount of contrast agent, magnetic field strength, precontrast T1 time, body composition, renal function and hematocrit To avoid these limitations, normalization of myocardial T1 values in relation to the blood T1 values has been proposed [16,17]. Precontrast T1 time, partition coefficient and ECV are positively associated, while post-contrast T1 time is negatively associated with presence of diffuse interstitial myocardial fibrosis
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