Author + information
- Received January 7, 2019
- Revision received May 31, 2019
- Accepted June 28, 2019
- Published online November 4, 2019.
- aDepartment of Medicine, Cardiovascular Division, University of Virginia Health System, Charlottesville, Virginia
- bSiemens Medical Solutions USA, Inc., Chicago, Illinois
- cRadiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia
- dDepartment of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
- ↵∗Address for correspondence:
Dr. Michael Salerno, Department of Medicine, Radiology, and Biomedical Engineering, Cardiovascular Division, University of Virginia Health System, 1215 Lee Street, P.O. Box 800158, Charlottesville, Virginia 22908.
• Mapping of myocardial T1 and ECV valves can provide noninvasive tissue characterization with powerful diagnostic, diminiscratory, and prognostic potential.
• Specific T1 and ECV values are dependent on several factors, including magnetic field strength, vendor, mapping technique, and sequence parameters.
• Each institution should develop and maintain a site-specific range of normal values.
• The field awaits the development of mapping techniques capable of whole-heart coverage, 3-dimensional datasets and free-breathing acquisition.
Myocardial native T1 and extracellular volume fraction (ECV) mapping have emerged as cardiac magnetic resonance biomarkers providing unique insight into cardiac pathophysiology. Single breath-hold acquisition techniques, available on clinical scanners across multiple vendor platforms, have made clinical T1 and ECV mapping a reality. Although the relationship between changes in native T1 and alterations in cardiac microstructure is complex, an understanding of how edema, blood volume, myocyte and interstitial expansion, lipids, and paramagnetic substances affect T1 and ECV can provide insight into how and why these parameters change in various cardiac pathologies. The goals of this state-of-the-art review will be to review factors influencing native T1 and ECV, to describe how native T1 and ECV are measured, to discuss potential challenges and pitfalls in clinical practice, and to describe new T1 mapping techniques on the horizon.
Funding sources include National Institutes of Health grants R01 HL131919 and T32 EB003841. Dr. Chow is an employee of Siemens Medical Solutions USA, Inc. Dr. Salerno has received research support from Siemens Medical Solutions USA, Inc. Dr. Robinson has reported that he has no relationships relevant to the contents of this paper to disclose.
- Received January 7, 2019.
- Revision received May 31, 2019.
- Accepted June 28, 2019.
- 2019 American College of Cardiology Foundation
This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click Login or the Subscribe link (top menu above) to access this article.