Extracellular volume fraction in dilated cardiomyopathy patients without obvious late gadolinium enhancement: comparison with healthy control subjects

  • Yoo Jin Hong
  • Chul Hwan Park
  • Young Jin Kim
  • Jin Hur
  • Hye-Jeong Lee
  • Sae Rom Hong
  • Young Joo Suh
  • Andreas Greiser
  • Mun Young Paek
  • Byoung Wook Choi
  • Tae Hoon KimEmail author
Original Paper


To evaluate whether the extracellular volume fraction (ECV) measured using cardiac magnetic resonance (CMR) imaging can detect myocardial tissue changes in dilated cardiomyopathy (DCM) without late gadolinium enhancement (LGE). Forty-one DCM patients and 10 healthy volunteers underwent pre- and post-T1 mapping using a modified Look-Locker Inversion recovery sequence, LGE, and cine MRI on a 3-T CMR system. LGE-MR findings were used to divide DCM patients into two groups: Group A had no apparent LGE, and Group B had LGE apparent in at least one segment. The ECV of the left ventricle (LV) myocardium (16 segments) was calculated in the short-axis view as follows: ECV = [(ΔR1 of myocardium/ΔR1 of LV blood pool)] × (1 − hematocrit), where R1 = 1/T1, ΔR1 = post-contrast R1 − pre-contrast R1. The LV ejection fraction (LVEF) was obtained from cine MRI images. The mean myocardial ECV in LGE (−) segments in Group A + B was compared to that of controls. The mean myocardial ECV in Group A was compared to that of LGE (−) segments in Group B. The correlation between LV systolic function and the mean myocardial ECV of the whole myocardium was evaluated in all groups. Among the 41 DCM patients, 22 were in Group A, and 19 were in Group B. The mean ECV of DCM patents (n = 41, 568 segments, 30.7 % ± 5.9) was significantly higher (P < 0.001) than that of the control group (n = 10, 157 segments, 25.6 % ± 3.2). The ECV was inversely related to LVEF in Group A (r = −0.551, P = 0.008), Group B (r = −0.525, P = 0.021), and Group A + B (r = −0.550, P < 0.001). The ECV measured by MRI could be a useful parameter in evaluating diffuse myocardial changes in DCM patients.


Cardiomyopathy Dilated Extracellular space Magnetic resonance imaging Gadolinium Fibrosis Myocardium T1 mapping 



Cardiac magnetic resonance


Dilated cardiomyopathy


Extracellular volume fraction


Late gadolinium enhancement


Left ventricle


Left-ventricular end-diastolic diameter


Left-ventricular ejection fraction


Modified Look-Locker Inversion recovery


Phase-sensitive inversion recovery


Right ventricle



This work was supported by a faculty research grant of Yonsei University College of Medicine for 2011 (6-2011-0190).

Conflict of interest



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Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • Yoo Jin Hong
    • 1
  • Chul Hwan Park
    • 2
  • Young Jin Kim
    • 1
  • Jin Hur
    • 1
  • Hye-Jeong Lee
    • 1
  • Sae Rom Hong
    • 1
  • Young Joo Suh
    • 1
  • Andreas Greiser
    • 3
  • Mun Young Paek
    • 4
  • Byoung Wook Choi
    • 1
  • Tae Hoon Kim
    • 2
    Email author
  1. 1.Department of Radiology, Research Institute of Radiological Science, Severance HospitalYonsei University Medical CenterSeoulSouth Korea
  2. 2.Department of Radiology, Research Institute of Radiological Science, Gangnam Severance HospitalYonsei University Medical CenterSeoulKorea
  3. 3.Siemens AG Healthcare SectorErlangenGermany
  4. 4.Siemens HealthcareSeoulRepublic of Korea

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