Variations of left ventricular myocardial signal on pre and post contrast cine Steady State Free Precession (SSFP) sequences in patients with cardiac amyloidosis

Congress:

ESCR 2014

Poster Number:

444

Type:

Scientific Poster

Keywords:

MR, Cardiac, MR-Diffusion/Perfusion, Computer Applications-Detection, diagnosis, Contrast agent-intravenous, Diagnostic procedure, Inflammation, Hyperplasia / Hypertrophy, Haematologic diseases

Authors:

C. Cholet¹, J. Mayer¹, F. Legou¹, F. Ridouani², T. Damy², A. Luciani¹, H. Kobeiter¹, A. Rahmouni¹, J. F. Deux¹; ¹Créteil/FR, ²Paris/FR

DOI:

DOI-Link:

https://dx.doi.org/

Fig. 1

Fig. 2

Fig. 3: SSFP sequence - Four chamber view

Fig. 4: SSFP sequence - short axis view

Purpose

Cardiac MR (CMR) can provide important informations in the diagnosis of cardiac amyloidosis (CA). Late Gadolinium Enhancement (LGE) sequences usually show a typical pattern of diffuse or subendocardial circumferential myocardial enhancement after gadolinium administration. An increase of myocardial thickness is frequently associated. Recently, some authors have reported that myocardial T1 is increased in CA using T1 mapping sequences. Steady State Free Precession (SSFP) cine sequences are currently used to measure left ventricular ejection fraction (LVEF) and ventricular volumes. The signal of SSFP images depends on...

Methods and Materials

Retrospective cohort study. 29 patients were included. All patients had a systemic amyloidosis (light chain or transthyretin) histologically confirmed. 17 patients with CA Cardiac amyloidosis was diagnosed on the presence of a myocardial hypertrophy (>12 mm) on echocardiography, associated with a diffuse myocardial enhancement and myocardial thickening on CMR. Diagnosis of CA was proved histologically in 4 (22%) patients. 12 patients with systemic amyloidosis (SA) but without CA The absence of CA was defined as a normal echocardiography (wall thickness > 12 mm, strain >15%...

Results

Myocardial SI measured before injection: Short axis view: Myocardial SI of patients with SA was significantlyhigher than patients with CA (p=0.04) and control group (p=0.001). Four chamber view: Myocardial SI of patients with SA was significantly higher than patients with CA and control group (p=0.02 each). Myocardial SI measured after injection: Short axis view: Myocardial SI was significantly higher in patient with CA and SA than in control groups (p<0.05). No significant difference was found between patients with CA and patients with SA. Four chamber...

Conclusion

Myocardial SI measured on SSFP sequences exhibited significant differences between control patients, patients with SA and patients with CA. Before injection, myocardial SI of patients with SA was significantly higher than control subjects and patients with CA: The signal of SSFP images depends on the T2/T1 tissue relaxation time ratio) and we think that this difference was probably due to a lengthening of myocardial T2, and not a shortening of myocardial T1. To the best of our knowledge this data has never been reported and...

References

Deux et Al, Acute Myocarditis: diagnostic value of contrast-enhanced cine steady-state free precession MRI sequences. AJR. Fontana et Al, Native T1 mapping in transthyretin amyloidosis. JACC Cardiovascular Imaging.