nach oben

Erschienen in:

07.03.2019 | Magnetic Resonance

Comparison of MR T1 and T2 mapping parameters to characterize myocardial and skeletal muscle involvement in systemic idiopathic inflammatory myopathy (IIM)

verfasst von: Adrian T. Huber, Jérôme Lamy, Marine Bravetti, Khaoula Bouazizi, Tania Bacoyannis, Charles Roux, Alain De Cesare, Aude Rigolet, Olivier Benveniste, Yves Allenbach, Mathieux Kerneis, Philippe Cluzel, Alban Redheuil, Nadjia Kachenoura

Erschienen in: European Radiology | Ausgabe 10/2019

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To compare the performance of magnetic resonance (MR) relaxometry parameters to discriminate myocardial and skeletal muscle inflammation in idiopathic inflammatory myopathy (IIM) patients from healthy controls.

Materials and methods

For this retrospective case-control study, 20 consecutive IIM patients (54 ± 18 years, 11 females) with cardiac involvement (troponin level > 50 ng/l) and 20 healthy controls (47 ± 12 years, 9 females) were included. All patients without cardiac MR imaging < 2 weeks prior to the laboratory testings were excluded. T1/T2 relaxation times, as well as T1-derived extracellular volume (ECV), relative tissue T1 shortening ΔT1 = (native T1_tissue-post contrast T1_tissue)/native T1_tissue), and enhancement fraction EHF = (native T1_tissue-post contrast T1_tissue)/(native T1_blood-post contrast T1_blood), were compared using Mann-Whitney U test and ROC analysis.

Results

All measured MR relaxometry parameters significantly discriminated IIM patients and healthy controls, except T2 in skeletal muscles and ECV in the myocardium. In skeletal muscles, post contrast T1 and T1-derived parameters showed the best performance to discriminate IIM patients from healthy controls (AUC = 0.98 for post contrast T1 and AUC 0.94–0.97 for T1-derived parameters). Inversely, in the myocardium, native T1 and T2 showed better diagnostic performance (AUC = 0.89) than post contrast T1 (AUC = 0.76), ECV (AUC = 0.58), ΔT1 (AUC = 0.80) and EHF (0.82).

Conclusions

MR relaxometry parameters applied to the myocardium and skeletal muscles might be useful to separate IIM patients from healthy controls. However, different tissue composition and vascularization should be taken into account for their interpretation. ΔT1 and EHF may be simple alternatives to ECV in highly vascularized tissues such as the myocardium.

Key Points

• MR relaxometry parameters applied to the myocardium and skeletal muscles are highly useful to separate IIM patients from healthy controls.

• Different tissue composition and vascularization should be taken into account for T1 and T2 mapping parameter interpretation.

• ΔT1 and EHF may be simple alternatives to ECV in highly vascularized tissues such as the myocardium.

Hamlin SA, Henry TS, Little BP, Lerakis S, Stillman AE (2014) Mapping the future of cardiac MR imaging: case-based review of T1 and T2 mapping techniques. Radiographics 34:1594–1611. https://doi.org/10.1148/rg.346140030

Schelbert EB, Messroghli DR (2016) State of the art: clinical applications of cardiac T1 mapping. Radiology 278:658–676. https://doi.org/10.1148/radiol.2016141802 CrossRefPubMed

Messroghli DR, Radjenovic A, Kozerke S, Higgins DM, Sivananthan MU, Ridgway JP (2004) Modified look-locker inversion recovery (MOLLI) for high-resolution T1 mapping of the heart. Magn Reson Med 52:141–146. https://doi.org/10.1002/mrm.20110

Roujol S, Weingärtner S, Foppa M et al (2014) Accuracy, precision, and reproducibility of four T1 mapping sequences: a head-to-head comparison of MOLLI, ShMOLLI, SASHA, and SAPPHIRE. Radiology 272:683–689. https://doi.org/10.1148/radiol.14140296 CrossRefPubMedPubMedCentral

Thavendiranathan P, Walls M, Giri S et al (2012) Improved detection of myocardial involvement in acute inflammatory cardiomyopathies using T2 mapping. Circ Cardiovasc Imaging 5:102–110. https://doi.org/10.1161/CIRCIMAGING.111.967836 CrossRefPubMed

Bellin MF, Van Der Molen AJ (2008) Extracellular gadolinium-based contrast media: an overview. Eur J Radiol 66:160–167. https://doi.org/10.1016/j.ejrad.2008.01.023 CrossRefPubMed

Strich G, Hagan PL, Gerber KH, Slutsky RA (1985) Tissue distribution and magnetic resonance spin lattice relaxation effects of gadolinium-DTPA. Radiology 154:723–726. https://doi.org/10.1148/radiology.154.3.3969477 CrossRefPubMed

Sueyoshi E, Sakamoto I, Uetani M (2009) Myocardial delayed contrast-enhanced MRI: relationships between various enhancing patterns and myocardial diseases. Br J Radiol 82:691–697. https://doi.org/10.1259/bjr/23291589 CrossRefPubMed

Kellman P, Wilson JR, Xue H, Ugander M, Arai AE (2012) Extracellular volume fraction mapping in the myocardium, part 1: evaluation of an automated method. J Cardiovasc Magn Reson 14:63

10.

Jerosch-Herold M, Sheridan DC, Kushner JD et al (2008) Cardiac magnetic resonance imaging of myocardial contrast uptake and blood flow in patients affected with idiopathic or familial dilated cardiomyopathy. Am J Physiol Heart Circ Physiol 295:H1234–H1242. https://doi.org/10.1152/ajpheart.00429.2008 CrossRefPubMedPubMedCentral

11.

Yoon JH, Lee JM, Paek M, Han JK, Choi BI (2016) Quantitative assessment of hepatic function: modified look-locker inversion recovery (MOLLI) sequence for T1 mapping on Gd-EOB-DTPA-enhanced liver MR imaging. Eur Radiol 26:1775–1782. https://doi.org/10.1007/s00330-015-3994-7

12.

Besa C, Bane O, Jajamovich G, Marchione J, Taouli B (2015) 3D T1 relaxometry pre and post gadoxetic acid injection for the assessment of liver cirrhosis and liver function. Magn Reson Imaging 33:1075–1082. https://doi.org/10.1016/j.mri.2015.06.013

13.

Haaf P, Garg P, Messroghli DR, Broadbent DA, Greenwood JP, Plein S (2016) Cardiac T1 mapping and extracellular volume (ECV) in clinical practice: a comprehensive review. J Cardiovasc Magn Reson 18:89. https://doi.org/10.1186/s12968-016-0308-4

14.

Miller CA, Naish JH, Bishop P et al (2013) Comprehensive validation of cardiovascular magnetic resonance techniques for the assessment of myocardial extracellular volume. Circ Cardiovasc Imaging 6:373–383. https://doi.org/10.1161/CIRCIMAGING.112.000192 CrossRefPubMed

15.

Lurz P, Luecke C, Eitel I et al (2016) Comprehensive cardiac magnetic resonance imaging in patients with suspected myocarditis: the MyoRacer-Trial. J Am Coll Cardiol 67:1800–1811. https://doi.org/10.1016/j.jacc.2016.02.013 CrossRefPubMed

16.

Ferreira VM, Piechnik SK, Dall’Armellina E et al (2013) T1 mapping for the diagnosis of acute myocarditis using CMR: comparison to T2-weighted and late gadolinium enhanced imaging. JACC Cardiovasc Imaging 6:1048–1058CrossRefPubMed

17.

Puntmann VO, Carr-White G, Jabbour A et al (2016) T1-mapping and outcome in nonischemic cardiomyopathy. JACC Cardiovasc Imaging 9:40–50. https://doi.org/10.1016/j.jcmg.2015.12.001 CrossRefPubMed

18.

Gupta R, Wayangankar SA, Targoff IN, Hennebry TA (2011) Clinical cardiac involvement in idiopathic inflammatory myopathies: a systematic review. Int J Cardiol 148:261–270. https://doi.org/10.1016/j.ijcard.2010.08.013 CrossRefPubMed

19.

Schwartz T, Diederichsen LP, Lundberg IE, Sjaastad I, Sanner H (2016) Cardiac involvement in adult and juvenile idiopathic inflammatory myopathies. RMD Open 2:e000291. https://doi.org/10.1136/rmdopen-2016-000291

20.

Huber AT, Bravetti M, Lamy J et al (2018) Non-invasive differentiation of idiopathic inflammatory myopathy with cardiac involvement from acute viral myocarditis using cardiovascular magnetic resonance imaging T1 and T2 mapping. J Cardiovasc Magn Reson 20:11. https://doi.org/10.1186/s12968-018-0430-6 CrossRefPubMedPubMedCentral

21.

Barison A, Gargani L, De Marchi D et al (2015) Early myocardial and skeletal muscle interstitial remodelling in systemic sclerosis: insights from extracellular volume quantification using cardiovascular magnetic resonance. Eur Heart J Cardiovasc Imaging 16:74–80. https://doi.org/10.1093/ehjci/jeu167

22.

Cieslar J, Huang MT, Dobson GP (1998) Tissue spaces in rat heart, liver, and skeletal muscle in vivo. Am J Physiol 275:R1530–R1536PubMed

23.

Iida H, Kanno I, Takahashi A et al (1988) Measurement of absolute myocardial blood flow with H215O and dynamic positron-emission tomography. Strategy for quantification in relation to the partial-volume effect. Circulation 78:104–115. https://doi.org/10.1161/01.CIR.78.1.104 CrossRefPubMed

24.

Ruotsalainen U, Raitakari M, Nuutila P et al (1997) Quantitative blood flow measurement of skeletal muscle using oxygen-15-water and PET. J Nucl Med 38:314–319PubMed

25.

Day J, Patel S, Limaye V (2017) The role of magnetic resonance imaging techniques in evaluation and management of the idiopathic inflammatory myopathies. Semin Arthritis Rheum 46:642–649. https://doi.org/10.1016/j.semarthrit.2016.11.001 CrossRefPubMed

26.

Bandula S, Banypersad SM, Sado D et al (2013) Measurement of tissue interstitial volume in healthy patients and those with amyloidosis with equilibrium contrast-enhanced MR imaging. Radiology 268:858–864. https://doi.org/10.1148/radiol.13121889 CrossRefPubMedPubMedCentral

27.

Sado DM, Flett AS, Banypersad SM et al (2012) Cardiovascular magnetic resonance measurement of myocardial extracellular volume in health and disease. Heart 98:1436–1441. https://doi.org/10.1136/heartjnl-2012-302346 CrossRefPubMed

28.

Fontana M, White SK, Banypersad SM et al (2012) Comparison of T1 mapping techniques for ECV quantification. Histological validation and reproducibility of ShMOLLI versus multibreath-hold T1 quantification equilibrium contrast CMR. J Cardiovasc Magn Reson 14:88. https://doi.org/10.1186/1532-429X-14-88 CrossRefPubMedPubMedCentral

29.

Koenig SH, Spiller M, Brown RD 3rd, Wolf GL (1986) Relaxation of water protons in the intra- and extracellular regions of blood containing Gd (DTPA). Magn Reson Med 3:791–795. https://doi.org/10.1002/mrm.1910030514

30.

Kostakou PM, Kostopoulos VS, Tryfou ES et al (2018) Subclinical left ventricular dysfunction and correlation with regional strain analysis in myocarditis with normal ejection fraction. A new diagnostic criterion. Int J Cardiol 259:116–121. https://doi.org/10.1016/j.ijcard.2018.01.058 CrossRefPubMed

Titel: Comparison of MR T1 and T2 mapping parameters to characterize myocardial and skeletal muscle involvement in systemic idiopathic inflammatory myopathy (IIM)
verfasst von: Adrian T. Huber
Jérôme Lamy
Marine Bravetti
Khaoula Bouazizi
Tania Bacoyannis
Charles Roux
Alain De Cesare
Aude Rigolet
Olivier Benveniste
Yves Allenbach
Mathieux Kerneis
Philippe Cluzel
Alban Redheuil
Nadjia Kachenoura
Publikationsdatum: 07.03.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 10/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06054-6

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Comparison of MR T1 and T2 mapping parameters to characterize myocardial and skeletal muscle involvement in systemic idiopathic inflammatory myopathy (IIM)