Abstract
Objective: For a correct estimation of extracellular volume, patients’ blood samples must be taken at least within 24 hours after cardiac magnetic resonance imaging, which may cause problems in immediate or retrospective evaluation. The aim of this study is to demonstrate the applicability of synthetic hematocrit for the calculation of extracellular volume.
 Materials and Methods: Cardiac magnetic resonance images including T1 mapping were retrospectively reviewed. Medical records of each patient were also collected and patients who had blood samples including hematocrit values within 24 hours of cardiac magnetic resonance imaging were included in the study. Simple linear regression along with intraclass correlation coefficient were used to calculate the coefficient of determination and agreement between the two measurements of hematocrit and extracellular volume values. The compatibility of the synthetic extracellular volume with the native extracellular volume was analysed using “Kappa Analysis”.
 Results: Synthetic and native hematocrit values showed significant correlation (p<0.001). Synthetic hematocrit had a high intraclass correlation coefficient (0.833). Kappa analysis for each region (Apex κ=0.88, Mid κ=0.75, Basal κ=0.87) showed significant interobserver reliability (p<0.001).
 Conclusion: Synthetic hematocrit formulas for each vendor may help improve synthetic extracellular volume values without contrast administration.
Highlights
Cardiac Magnetic Resonance Imaging (CMR), in addition to assessing cardiac anatomy and myocardial motion, is a part of the main work-up to study myocardial pathology due to its superior tissue characterization and enhancement properties
Synthetic hematocrit formulas for each vendor may help improve synthetic extracellular volume values without contrast administration
Our results showed that synthetic Extracellular volume (ECV) values estimated from three different regions of the myocardium showed excellent correlation with native ECV
Summary
Cardiac Magnetic Resonance Imaging (CMR), in addition to assessing cardiac anatomy and myocardial motion, is a part of the main work-up to study myocardial pathology due to its superior tissue characterization and enhancement properties. Myocardial scar tissue, fibrosis, or edema show late gadolinium enhancement due to retention of contrast in the extracellular space, which has an increased volume in these pathologies [1]. Extracellular volume (ECV) indirectly indicates cardiac remodelling and is a quantitative parameter for prognosis of myocardial pathologies [2]. T1 mapping techniques grant quantification of fibrosis, and allow the diagnosis of myocardial disease [3,4,5]. T1 mapping allows the estimation of the longitudinal relaxation time (known as the T1 value), i.e., the rate at which protons to regain their longitudinal magnetization after a radiofrequency
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