PMID- 22967246
OWN - NLM
STAT- MEDLINE
DCOM- 20121218
LR  - 20240117
IS  - 1532-429X (Electronic)
IS  - 1097-6647 (Print)
IS  - 1097-6647 (Linking)
VI  - 14
IP  - 1
DP  - 2012 Sep 11
TI  - Extracellular volume fraction mapping in the myocardium, part 2: initial clinical 
      experience.
PG  - 64
LID - 10.1186/1532-429X-14-64 [doi]
AB  - BACKGROUND: Diffuse myocardial fibrosis, and to a lesser extent global myocardial 
      edema, are important processes in heart disease which are difficult to assess or 
      quantify with cardiovascular magnetic resonance (CMR) using conventional late 
      gadolinium enhancement (LGE) or T1-mapping. Measurement of the myocardial 
      extracellular volume fraction (ECV) circumvents factors that confound T1-weighted 
      images or T1-maps. We hypothesized that quantitative assessment of myocardial ECV 
      would be clinically useful for detecting both focal and diffuse myocardial 
      abnormalities in a variety of common and uncommon heart diseases. METHODS: A 
      total of 156 subjects were imaged including 62 with normal findings, 33 patients 
      with chronic myocardial infarction (MI), 33 with hypertrophic cardiomyopathy 
      (HCM), 15 with non-ischemic dilated cardiomyopathy (DCM), 7 with acute 
      myocarditis, 4 with cardiac amyloidosis, and 2 with systemic capillary leak 
      syndrome (SCLS). Motion corrected ECV maps were generated automatically from 
      T1-maps acquired pre- and post-contrast calibrated by blood hematocrit. 
      Abnormally-elevated ECV was defined as >2SD from the mean ECV in individuals with 
      normal findings. In HCM the size of regions of LGE was quantified as the region 
      >2 SD from remote. RESULTS: Mean ECV of 62 normal individuals was 25.4 +/- 2.5% (m 
      +/- SD), normal range 20.4%-30.4%. Mean ECV within the core of chronic myocardial 
      infarctions (without MVO) (N=33) measured 68.5 +/- 8.6% (p<0.001 vs normal). In 
      HCM, the extent of abnormally elevated ECV correlated to the extent of LGE 
      (r=0.72, p<0.001) but had a systematically greater extent by ECV (mean difference 
      19 +/- 7% of slice). Abnormally elevated ECV was identified in 4 of 16 patients 
      with non-ischemic DCM (38.1 +/- 1.9% (p<0.001 vs normal) and LGE in the same slice 
      appeared "normal" in 2 of these 4 patients. Mean ECV values in other disease 
      entities ranged 32-60% for cardiac amyloidosis (N=4), 40-41% for systemic 
      capillary leak syndrome (N=2), and 39-56% within abnormal regions affected by 
      myocarditis (N=7). CONCLUSIONS: ECV mapping appears promising to complement LGE 
      imaging in cases of more homogenously diffuse disease. The ability to display ECV 
      maps in units that are physiologically intuitive and may be interpreted on an 
      absolute scale offers the potential for detection of diffuse disease and 
      measurement of the extent and severity of abnormal regions.
FAU - Kellman, Peter
AU  - Kellman P
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, MD, USA. kellmanp@nhlbi.nih.gov
FAU - Wilson, Joel R
AU  - Wilson JR
FAU - Xue, Hui
AU  - Xue H
FAU - Bandettini, W Patricia
AU  - Bandettini WP
FAU - Shanbhag, Sujata M
AU  - Shanbhag SM
FAU - Druey, Kirk M
AU  - Druey KM
FAU - Ugander, Martin
AU  - Ugander M
FAU - Arai, Andrew E
AU  - Arai AE
LA  - eng
GR  - ZIA HL004607-14/Intramural NIH HHS/United States
GR  - ZID HL006140-02/Intramural NIH HHS/United States
GR  - ZID HL006140-01/Intramural NIH HHS/United States
GR  - ZIE HL006139-02/Intramural NIH HHS/United States
GR  - ZIE HL006139-01/Intramural NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
DEP - 20120911
PL  - England
TA  - J Cardiovasc Magn Reson
JT  - Journal of cardiovascular magnetic resonance : official journal of the Society 
      for Cardiovascular Magnetic Resonance
JID - 9815616
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Fibrosis
MH  - Follow-Up Studies
MH  - Heart Diseases/*pathology
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Retrospective Studies
PMC - PMC3442966
EDAT- 2012/09/13 06:00
MHDA- 2012/12/19 06:00
PMCR- 2012/09/11
CRDT- 2012/09/13 06:00
PHST- 2012/05/02 00:00 [received]
PHST- 2012/09/03 00:00 [accepted]
PHST- 2012/09/13 06:00 [entrez]
PHST- 2012/09/13 06:00 [pubmed]
PHST- 2012/12/19 06:00 [medline]
PHST- 2012/09/11 00:00 [pmc-release]
AID - S1097-6647(23)00687-7 [pii]
AID - 1532-429X-14-64 [pii]
AID - 10.1186/1532-429X-14-64 [doi]
PST - epublish
SO  - J Cardiovasc Magn Reson. 2012 Sep 11;14(1):64. doi: 10.1186/1532-429X-14-64.