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Stress T1-mapping cardiovascular magnetic resonance imaging and inducible myocardial ischemia

  • Sebastian BohnenEmail author
  • Lennard Prüßner
  • E. Vettorazzi
  • Ulf K. Radunski
  • Enver Tahir
  • Jan Schneider
  • Ersin Cavus
  • Maxim Avanesov
  • Christian Stehning
  • Gerhard Adam
  • Stefan Blankenberg
  • Gunnar K. Lund
  • Kai Muellerleile
Original Paper
  • 46 Downloads

Abstract

Background

Alterations in native myocardial T1 under vasodilation stress (“T1 reactivity”) were recently proposed as a non-contrast cardiovascular magnetic resonance (CMR) method to detect myocardial ischemia. This study evaluated the performance of a segmental, truly non-contrast stress T1 mapping CMR approach to detect inducible ischemia.

Methods and results

One-hundred patients with suspected/known coronary artery disease underwent CMR at 3.0 or 1.5 T. T1 mapping was performed using the 5s(3s)3s-modified look-locker inversion-recovery (MOLLI) sequence at rest and under regadenoson stress. We defined T1 reactivity as the change in native T1 from rest to stress (1) in the 16-segment AHA model independent from perfusion images and (2) in focal regions of interest that were copied from perfusion images to T1 maps. We compared T1 reactivity between segments/regions with inducible ischemia, scar, and remote myocardium for both approaches. Segmental T1 reactivity was significantly lower in segments including inducible ischemia [− 1.15 (95% CI, − 2.16 to − 0.14)%] compared to remote segments [2.49 (95% CI, 1.87 to 3.11)%; p < 0.001]. Focal T1 reactivity was also significantly lower [− 2.65 (95% CI, − 3.84 to − 1.46)%] in regions with stress-perfusion defects compared to remote regions [4.72 (95% CI, 3.90 to 5.54)%; p < 0.001]. However, the performance of segmental T1 reactivity to depict inducible ischemia was significantly inferior compared to the focal approach (AUCs 0.68 versus 0.85; p < 0.0001).

Conclusions

Myocardium with inducible ischemia is characterized by the absence of significant T1 reactivity, but a clinically applicable approach for truly non-contrast stress T1 mapping remains to be determined.

Keywords

T1 mapping T1 reactivity CMR Ischemia 

Notes

Compliance with ethical standards

Conflict of interest

Dr. Stehning is an employee of Philips Research, Hamburg, Germany. The other authors report no conflicts.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Sebastian Bohnen
    • 1
    Email author
  • Lennard Prüßner
    • 1
  • E. Vettorazzi
    • 2
  • Ulf K. Radunski
    • 1
  • Enver Tahir
    • 3
  • Jan Schneider
    • 1
  • Ersin Cavus
    • 1
  • Maxim Avanesov
    • 3
  • Christian Stehning
    • 4
  • Gerhard Adam
    • 3
  • Stefan Blankenberg
    • 1
  • Gunnar K. Lund
    • 3
  • Kai Muellerleile
    • 1
  1. 1.General and Interventional Cardiology, University Heart CenterUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Department of Medical Biometry and EpidemiologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  3. 3.Department of Diagnostic and Interventional Radiology and Nuclear MedicineUniversity Medical Center Hamburg-EppendorfHamburgGermany
  4. 4.Philips Research HamburgUniversity Medical Center Hamburg-EppendorfHamburgGermany

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