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Quantitative diffusion-weighted magnetic resonance imaging in the assessment of myocardial fibrosis in hypertrophic cardiomyopathy compared with T1 mapping

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Abstract

To identify myocardial fibrosis in hypertrophic cardiomyopathy (HCM) subjects using quantitative cardiac diffusion-weighted imaging (DWI) and to compare its performance with native T1 mapping and extracellular volume (ECV). Thirty-eight HCM subjects (mean age, 53 ± 9 years) and 14 normal controls (mean age, 51 ± 8 years) underwent cardiac magnetic resonance imaging (CMRI) on a 3.0T magnetic resonance (MR) machine with DWI, T1 mapping and late gadolinium enhancement (LGE) imaging as the reference standard. The mean apparent diffusion coefficient (ADC), native T1 value and ECV were determined for each subject. Overall, the HCM subjects exhibited an increased native T1 value (1241.04 ± 78.50 ms), ECV (0.31 ± 0.03) and ADC (2.36 ± 0.34 s/mm2) compared with the normal controls (1114.60 ± 37.99 ms, 0.24 ± 0.04, and 1.62 ± 0.38 s/mm2, respectively) (p < 0.05). DWI differentiated healthy and fibrotic myocardia with an area under the curve (AUC) of 0.93, while the AUCs of the native T1 values (0.93), (p > 0.05) and ECV (0.94), (p > 0.05) exhibited an equal differentiation ability. Both HCM LGE+ and HCM LGE− subjects had an increased native T1 value, ECV and ADC compared to the normal controls (p < 0.05). HCM LGE+ subjects exhibited an increased ECV (0.31 ± 0.04) and ADC (2.43 ± 0.36 s/mm2) compared to HCM LGE− subjects (p < 0.05). HCM LGE+ and HCM LGE− subjects had similar native T1 values (1250 ± 76.36 ms vs. 1213.98 ± 92.30 ms, respectively) (p > 0.05). ADC values were linearly associated with increased ECV (R2 = 0.36) and native T1 values (R2 = 0.40) among all subjects. DWI is a feasible alternative to native T1 mapping and ECV for the identification of myocardial fibrosis in patients with HCM. DWI and ECV can quantitatively characterize the extent of fibrosis in HCM LGE+ and HCM LGE− patients.

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Funding

This study was funded by National Natural Science Foundation of China (Youth Program No. 81401403).

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Authors and Affiliations

  1. Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

    Lian-Ming Wu, Bing-Hua Chen, Qiu-Ying Yao, Yang-Rongzheng Ou, Rui Wu, Dong-Aolei An & Jian-Rong Xu

  2. Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

    Meng Jiang

  3. Department of Radiology, Wayne State University, Detroit, MI, USA

    Jiani Hu

Authors
  1. Lian-Ming Wu
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  2. Bing-Hua Chen
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  3. Qiu-Ying Yao
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  4. Yang-Rongzheng Ou
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  5. Rui Wu
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Correspondence to Jian-Rong Xu.

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All procedures performed in this study that involved human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Wu, LM., Chen, BH., Yao, QY. et al. Quantitative diffusion-weighted magnetic resonance imaging in the assessment of myocardial fibrosis in hypertrophic cardiomyopathy compared with T1 mapping. Int J Cardiovasc Imaging 32, 1289–1297 (2016). https://doi.org/10.1007/s10554-016-0909-x

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  • DOI: https://doi.org/10.1007/s10554-016-0909-x

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