Department of Cardiology, Guys and St Thomas' NHS Trust, Westminster Bridge Road, London, UK.
Cardiovascular Division, King's College London, The Rayne Institute. St Thomas' Hospital, Westminster Bridge Road, London SE5 9RS, UK.
Eur Heart J Cardiovasc Imaging. 2018 Jul 1;19(7):768-776. doi: 10.1093/ehjci/jex309.
To determine the bioequivalence of several T1 mapping sequences in myocardial characterization of diffuse myocardial fibrosis.
We performed an intra-individual sequence comparison of three types of T1 mapping sequences [MOdified Look-Locker Inversion recovery (MOLLI), Shortened MOdified Look-Locker Inversion recovery ((sh)MOLLI), and SAturation recovery single-SHot Acquisition (SASHA)]. We employed two model diseases of diffuse interstitial fibrosis [patients with non-ischaemic dilated cardiomyopathy (NIDCM), n = 32] and aortic stenosis [(AS), n = 25)]. Twenty-six healthy individuals served as controls. Relationship with collagen volume fraction (CVF) was assessed using endomyocardial biopsies (EMB) intraoperatively in 12 AS patients. T2 mapping (GraSE) was also performed. Myocardial native T1 with MOLLI and shMOLLI showed, firstly, an excellent discriminatory accuracy between health and disease [area under the curves (P-value): 0.94 (0.88-0.99); 0.87 (0.79-0.94); 0.61 (0.49-0.72)], secondly, relationship between histological CVF [native T1 MOLLI vs. shMOLLI vs. SASHA: r = 0.582 (P = 0.027), r = 0.524 (P = 0.046), r = 0.443 (P = 0.150)], and thirdly, with native T2 [r = 0.628(P < 0.001), r = 0.459 (P = 0.003), r = 0.211 (P = 0.083)]. The respective relationships for extracellular volume fraction with CVF [r = 0.489 (P = 0.044), r = 0.417 (0.071), r = 0.353 (P = 0.287)] were significant for MOLLI, but not other sequences. In AS patients, native T2 was significantly higher compared to controls, and associated with levels of C-reactive protein and troponin.
T1 mapping sequences differ in their bioequivalence for discrimination between health and disease as well as associations with diffuse myocardial fibrosis.
确定心肌弥漫性纤维化特征的几种 T1 映射序列的生物等效性。
我们对三种 T1 映射序列[改良 Look-Locker 反转恢复（MOLLI）、缩短的 MOLLI（shMOLLI）和饱和恢复单 shot 采集（SASHA）]进行了个体内序列比较。我们使用两种弥漫性间质纤维化的模型疾病[非缺血性扩张型心肌病（NIDCM）患者，n=32]和主动脉瓣狭窄[（AS），n=25]。26 名健康个体作为对照。在 12 名 AS 患者的术中进行心内膜心肌活检（EMB）评估与胶原容积分数（CVF）的关系。还进行了 T2 映射（GraSE）。MOLLI 和 shMOLLI 的心肌固有 T1 首先在健康和疾病之间具有出色的区分准确性[曲线下面积（P 值）：0.94（0.88-0.99）；0.87（0.79-0.94）；0.61（0.49-0.72）]，其次，与组织学 CVF 之间存在关系[固有 T1 MOLLI 与 shMOLLI 与 SASHA 相比：r=0.582（P=0.027），r=0.524（P=0.046），r=0.443（P=0.150）]，第三，与固有 T2 相关[r=0.628（P<0.001），r=0.459（P=0.003），r=0.211（P=0.083）]。MOLLI 与 CVF 之间细胞外容积分数的相应关系[r=0.489（P=0.044），r=0.417（0.071），r=0.353（P=0.287）]也具有统计学意义，但其他序列没有。在 AS 患者中，与对照组相比，固有 T2 明显升高，与 C 反应蛋白和肌钙蛋白水平相关。
T1 映射序列在区分健康和疾病以及与弥漫性心肌纤维化的相关性方面存在生物等效性差异。
