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Role of cardiac T1 mapping and extracellular volume in the assessment of myocardial infarction [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-39586 | DOI: 10.14744/AnatolJCardiol.2018.39586  

Role of cardiac T1 mapping and extracellular volume in the assessment of myocardial infarction

Pankaj Garg1, Laura C Saunders1, Andrew J Swift1, Jim M Wild1, Sven Plein2
1Department of Infection, Immunity&Cardiovascular Disease, University of Sheffield; Sheffield-United Kingdom
2Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds; Leeds-United Kingdom

Although late gadolinium enhancement on cardiac magnetic resonance imaging remains the reference standard for scar assessment, it does not provide quantitative information about the extent of pathophysiological changes within the scar tissue. T1 mapping and extracellular volume (ECV) mapping are steadily becoming diagnostic and prognostically useful tests for in vivo myocardial histology, influencing clinical decision-making. Quantitative native T1 maps (acquired without a contrast agent) represent the longitudinal relaxation time within the myocardium and changes with myocardial extracellular water (edema, focal, or diffuse fibrosis), fat, iron, and amyloid protein content. Post-contrast ECV maps estimate the size of the extracellular space and have sensitivity in the identification of interstitial disease. Both pre- and post-contrast T1 mapping are emerging as comprehensive tools for the assessment of numerous conditions including ischemic scarring that occurs post myocardial infarction (MI). This review outlines the current evidence and potential future role of T1 mapping in MI. We conclude by highlighting some of the remaining challenges such as quality control, standardization of image acquisition for clinical practice, and automated methods for quantifying infarct size, area at risk, and myocardial salvage post MI.

Keywords: magnetic resonance imaging, gadolinium, extracellular space, myocardial infarction, edema

Corresponding Author: Pankaj Garg, United Kingdom

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