T1 mapping - myocardium

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T1 mapping is a magnetic resonance imaging techniqueused to calculate the T1 time of a certain tissue and display them voxel-vice on a parametric map. It has been used for myocardial tissue characterization 1-6 and has been investigated for other tissues 5.

T1 is the spin-lattice or longitudinal relaxation time of tissue and a parametric T1 map depicts those values within its voxels 1-6. T1 reflects changes in intracellular and extracellular compartments and is affected by collagen, protein, water (oedema), lipids and iron content 1-5. The histopathological correlate of myocardial T1, however, has still not been completely elucidated 1.

Native T1 is referred to as the T1 time measured in the absence of a contrast agent 1-3, whereas postcontrast T1 measured after the application of gadolinium is used to calculate extracellular volume (ECV), a surrogate parameter for the extracellular matrix  1-4. Both native T1 and ECV can be used as biomarkers 1,2.

Alterations in native T1 are not specific and in the myocardium, they reflect changes in tissue composition.  Together with other imaging or clinical parameters they can help in the diagnosis 1,2.

Methodology

T1 mapping can be conducted with several different acquisition methods (MOLLI, ShMOLLI, STONE, SASHA, SAPPHIRE) based on balanced SSFP sequences 2,5. Following either an inversion or saturation preparation a series of co-registered images is acquired at different T1 recovery times 2.

T1 values can then be computed pixel-wise from a signal intensity versus time curve fitting model 2,5. Motion between the images needs to be corrected otherwise this will have an adverse effect on the measured T1 values 2,3,5.

The voxels can then be quantified and evaluated either on the basis of normal reference values in diffuse disease or compared to the healthy myocardium in focal disease 2.

If the second set of T1 images after the administration of a gadolinium-based contrast agent is acquired and co-registered to the first native set, an extracellular volume (ECV) map can be generated 1-3.

Interpretation

Native T1 is related to water, protein, lipid and iron content of the respective tissue and expresses the signal from the intracellular and extracellular compartments 1,5,7

Postcontrast T1 is shorter than native T1, mainly reflects the extracellular compartments and used to calculate extracellular volume after adjusting for haematocrit 1-5,7.

Extracellular volume (ECV) reflects the space, which is not occupied by cells and also includes the intracapillary plasma volume 1. It correlates with the collagen volume fraction but also increases in the presence of amyloid or myocardial oedema 1.  In the absence of the two latter and other forms of an infiltrative disease, it can be seen as a biomarker for interstitial disease or myocardial fibrosis 1-4.

Influencing factors

Myocardial T1 depends on the pulse sequence, cardiac cycle as well as other factors and increases at higher magnetic field strength 6.

Clinical applications

T1-mapping can detect a variety of myocardial pathologies, where it shows increased values 2-5:

In addition, it can be used in the following pathologies due to low values 2,5:

The calculation of extracellular volume (ECV) is considered as reasonable in patients getting an extracellular contrast agent and give additional information in some of the above-mentioned pathologies 2-5.

Normal values

Normal values of T1 times differ depending on magnetic field strength (1.5 and 3 tesla) and acquisition sequence (MOLLI, shMOLLI, SASHA, SAPPHIRE). Because of variations between scanners the primary use of a local reference range is recommended 1,2 and if a local reference range is not available quantitative results should not be clinically reported 1,2.

See also

  • -<p><strong>T1 mapping </strong>is a magnetic resonance imaging technique<strong> </strong>used to calculate the <a href="/articles/t1-values-15-t">T1 time</a> of a certain tissue and display them voxel-vice on a parametric map. It has been used for <a href="/articles/cardiac-tissue-characterization">myocardial tissue characterization</a> <sup>1-6 </sup>and has been investigated for other tissues <sup>5</sup>.</p><p><a href="/articles/t1-weighted-image">T1</a> is the spin-lattice or longitudinal relaxation time of tissue and a parametric T1 map depicts those values within its voxels <sup>1-6</sup>. T1 reflects changes in intracellular and extracellular compartments and is affected by collagen, protein, water (oedema), lipids and iron content<sup> 1-5</sup>. The histopathological correlate of myocardial T1, however, has still not been completely elucidated <sup>1</sup>.</p><p>Native T1 is referred to as the T1 time measured in the absence of a contrast agent <sup>1-3</sup>, whereas postcontrast T1 measured after the application of gadolinium is used to calculate <a href="/articles/extracellular-volume-ecv-myocardium">extracellular volume (ECV)</a>, a surrogate parameter for the extracellular matrix <sup> 1-4</sup>. Both native T1 and ECV can be used as biomarkers <sup>1,2</sup>.</p><p>Alterations in native T1 are not specific and in the myocardium, they reflect changes in tissue composition.  Together with other imaging or clinical parameters they can help in the diagnosis <sup>1,2</sup>.</p><h4>Methodology</h4><p>T1 mapping can be conducted with several different acquisition methods (MOLLI, ShMOLLI, STONE, SASHA, SAPPHIRE) based on balanced <a href="/articles/steady-state-free-precession-mri-2">SSFP sequences</a> <sup>2,5</sup>. Following either an inversion or saturation preparation a series of co-registered images is acquired at different T1 recovery times <sup>2</sup>.</p><p><a href="/articles/t1-values-15-t">T1 values</a> can then be computed pixel-wise from a signal intensity versus time curve fitting model <sup>2,5</sup>. Motion between the images needs to be corrected otherwise this will have an adverse effect on the measured T1 values <sup>2,3,5</sup>.</p><p>The voxels can then be quantified and evaluated either on the basis of normal reference values in diffuse disease or compared to the healthy myocardium in focal disease <sup>2</sup>.</p><p>If the second set of T1 images after the administration of a gadolinium-based contrast agent is acquired and co-registered to the first native set, an <a href="/articles/extracellular-volume-ecv-myocardium">extracellular volume (ECV)</a> map can be generated <sup>1-3</sup>.</p><h4>Interpretation</h4><p>Native T1 is related to water, protein, lipid and iron content of the respective tissue and expresses the signal from the intracellular and extracellular compartments <sup>1,5,7</sup>. </p><p>Postcontrast T1 is shorter than native T1, mainly reflects the extracellular compartments and used to calculate extracellular volume after adjusting for haematocrit <sup>1-5,7</sup>.</p><p><a href="/articles/extracellular-volume-ecv-myocardium">Extracellular volume (ECV)</a> reflects the space, which is not occupied by cells and also includes the intracapillary plasma volume <sup>1</sup>. It correlates with the collagen volume fraction but also increases in the presence of amyloid or <a href="/articles/myocardial-oedema">myocardial oedema</a> <sup>1</sup>.  In the absence of the two latter and other forms of an infiltrative disease, it can be seen as a biomarker for interstitial disease or <a href="/articles/myocardial-fibrosis">myocardial fibrosis</a> <sup>1-4</sup>.</p><h5>Influencing factors</h5><p>Myocardial T1 depends on the pulse sequence, cardiac cycle as well as other factors and increases at higher magnetic field strength <sup>6</sup>.</p><h5>Clinical applications</h5><p>T1-mapping can detect a variety of myocardial pathologies, where it shows increased values <sup>2-5</sup>:</p><ul>
  • +<p><strong>T1 mapping </strong>is a magnetic resonance imaging technique<strong> </strong>used to calculate the <a href="/articles/t1-values-15-t">T1 time</a> of a certain tissue and display them voxel-vice on a parametric map. It has been used for <a href="/articles/cardiac-tissue-characterization">myocardial tissue characterization</a> <sup>1-6 </sup>and has been investigated for other tissues <sup>5</sup>.</p><p><a href="/articles/t1-weighted-image">T1</a> is the spin-lattice or longitudinal relaxation time of tissue and a parametric T1 map depicts those values within its voxels <sup>1-6</sup>. T1 reflects changes in intracellular and extracellular compartments and is affected by collagen, protein, water (oedema), lipids and iron content<sup> 1-5</sup>. The histopathological correlate of myocardial T1, however, has still not been completely elucidated <sup>1</sup>.</p><p>Native T1 is referred to as the T1 time measured in the absence of a contrast agent <sup>1-3</sup>, whereas postcontrast T1 measured after the application of gadolinium is used to calculate <a href="/articles/extracellular-volume-myocardium">extracellular volume (ECV)</a>, a surrogate parameter for the extracellular matrix <sup> 1-4</sup>. Both native T1 and ECV can be used as biomarkers <sup>1,2</sup>.</p><p>Alterations in native T1 are not specific and in the myocardium, they reflect changes in tissue composition.  Together with other imaging or clinical parameters they can help in the diagnosis <sup>1,2</sup>.</p><h4>Methodology</h4><p>T1 mapping can be conducted with several different acquisition methods (MOLLI, ShMOLLI, STONE, SASHA, SAPPHIRE) based on balanced <a href="/articles/steady-state-free-precession-mri-2">SSFP sequences</a> <sup>2,5</sup>. Following either an inversion or saturation preparation a series of co-registered images is acquired at different T1 recovery times <sup>2</sup>.</p><p><a href="/articles/t1-values-15-t">T1 values</a> can then be computed pixel-wise from a signal intensity versus time curve fitting model <sup>2,5</sup>. Motion between the images needs to be corrected otherwise this will have an adverse effect on the measured T1 values <sup>2,3,5</sup>.</p><p>The voxels can then be quantified and evaluated either on the basis of normal reference values in diffuse disease or compared to the healthy myocardium in focal disease <sup>2</sup>.</p><p>If the second set of T1 images after the administration of a gadolinium-based contrast agent is acquired and co-registered to the first native set, an <a href="/articles/extracellular-volume-ecv-myocardium">extracellular volume (ECV)</a> map can be generated <sup>1-3</sup>.</p><h4>Interpretation</h4><p>Native T1 is related to water, protein, lipid and iron content of the respective tissue and expresses the signal from the intracellular and extracellular compartments <sup>1,5,7</sup>. </p><p>Postcontrast T1 is shorter than native T1, mainly reflects the extracellular compartments and used to calculate extracellular volume after adjusting for haematocrit <sup>1-5,7</sup>.</p><p><a href="/articles/extracellular-volume-ecv-myocardium">Extracellular volume (ECV)</a> reflects the space, which is not occupied by cells and also includes the intracapillary plasma volume <sup>1</sup>. It correlates with the collagen volume fraction but also increases in the presence of amyloid or <a href="/articles/myocardial-oedema">myocardial oedema</a> <sup>1</sup>.  In the absence of the two latter and other forms of an infiltrative disease, it can be seen as a biomarker for interstitial disease or <a href="/articles/myocardial-fibrosis">myocardial fibrosis</a> <sup>1-4</sup>.</p><h5>Influencing factors</h5><p>Myocardial T1 depends on the pulse sequence, cardiac cycle as well as other factors and increases at higher magnetic field strength <sup>6</sup>.</p><h5>Clinical applications</h5><p>T1-mapping can detect a variety of myocardial pathologies, where it shows increased values <sup>2-5</sup>:</p><ul>

References changed:

  • 1. Moon J, Messroghli D, Kellman P et al. Myocardial T1 Mapping and Extracellular Volume Quantification: A Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology Consensus Statement. J Cardiovasc Magn Reson. 2013;15(1):92. <a href="https://doi.org/10.1186/1532-429X-15-92">doi:10.1186/1532-429X-15-92</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/24124732">Pubmed</a>
  • 2. Messroghli D, Moon J, Ferreira V et al. Clinical Recommendations for Cardiovascular Magnetic Resonance Mapping of T1, T2, T2* and Extracellular Volume: A Consensus Statement by the Society for Cardiovascular Magnetic Resonance (SCMR) Endorsed by the European Association for Cardiovascular Imaging (EACVI). J Cardiovasc Magn Reson. 2017;19(1):75. <a href="https://doi.org/10.1186/s12968-017-0389-8">doi:10.1186/s12968-017-0389-8</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/28992817">Pubmed</a>
  • 3. Ferreira V, Piechnik S, Robson M, Neubauer S, Karamitsos T. Myocardial Tissue Characterization by Magnetic Resonance Imaging: Novel Applications of T1 and T2 Mapping. J Thorac Imaging. 2014;29(3):147-54. <a href="https://doi.org/10.1097/RTI.0000000000000077">doi:10.1097/RTI.0000000000000077</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/24576837">Pubmed</a>
  • 4. Salerno M & Kramer C. Advances in Parametric Mapping With CMR Imaging. JACC Cardiovasc Imaging. 2013;6(7):806-22. <a href="https://doi.org/10.1016/j.jcmg.2013.05.005">doi:10.1016/j.jcmg.2013.05.005</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/23845576">Pubmed</a>
  • 5. Haaf P, Garg P, Messroghli D, Broadbent D, Greenwood J, Plein S. Cardiac T1 Mapping and Extracellular Volume (ECV) in Clinical Practice: A Comprehensive Review. J Cardiovasc Magn Reson. 2016;18(1):89. <a href="https://doi.org/10.1186/s12968-016-0308-4">doi:10.1186/s12968-016-0308-4</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/27899132">Pubmed</a>
  • 6. Dekkers I & Lamb H. Clinical Application and Technical considerations of T1 & T2(*) Mapping in Cardiac, Liver, and Renal Imaging. BJR. 2018;91(1092):20170825. <a href="https://doi.org/10.1259/bjr.20170825">doi:10.1259/bjr.20170825</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/29975154">Pubmed</a>
  • 7. Schumann C, Jaeger N, Kramer C. Recent Advances in Imaging of Hypertensive Heart Disease. Curr Hypertens Rep. 2019;21(1):3. <a href="https://doi.org/10.1007/s11906-019-0910-6">doi:10.1007/s11906-019-0910-6</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30637533">Pubmed</a>
  • 8. Schelbert E & Messroghli D. State of the Art: Clinical Applications of Cardiac T1 Mapping. Radiology. 2016;278(3):658-76. <a href="https://doi.org/10.1148/radiol.2016141802">doi:10.1148/radiol.2016141802</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/26885733">Pubmed</a>
  • 1. Moon JC, Messroghli DR, Kellman P, Piechnik SK, Robson MD, Ugander M, Gatehouse PD, Arai AE, Friedrich MG, Neubauer S, Schulz-Menger J, Schelbert EB. Myocardial T1 mapping and extracellular volume quantification: a Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology consensus statement. (2013) Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. 15: 92. <a href="https://doi.org/10.1186/1532-429X-15-92">doi:10.1186/1532-429X-15-92</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/24124732">Pubmed</a> <span class="ref_v4"></span>
  • 2. Daniel R. Messroghli, James C. Moon, Vanessa M. Ferreira, Lars Grosse-Wortmann, Taigang He, Peter Kellman, Julia Mascherbauer, Reza Nezafat, Michael Salerno, Erik B. Schelbert, Andrew J. Taylor, Richard Thompson, Martin Ugander, Ruud B. van Heeswijk, Matthias G. Friedrich. Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: A consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI). (2017) Journal of Cardiovascular Magnetic Resonance. 19 (1): 1. <a href="https://doi.org/10.1186/s12968-017-0389-8">doi:10.1186/s12968-017-0389-8</a> <span class="ref_v4"></span>
  • 3. Ferreira VM, Piechnik SK, Robson MD, Neubauer S, Karamitsos TD. Myocardial tissue characterization by magnetic resonance imaging: novel applications of T1 and T2 mapping. (2014) Journal of thoracic imaging. 29 (3): 147-54. <a href="https://doi.org/10.1097/RTI.0000000000000077">doi:10.1097/RTI.0000000000000077</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/24576837">Pubmed</a> <span class="ref_v4"></span>
  • 4. Salerno M, Kramer CM. Advances in parametric mapping with CMR imaging. (2013) JACC. Cardiovascular imaging. 6 (7): 806-22. <a href="https://doi.org/10.1016/j.jcmg.2013.05.005">doi:10.1016/j.jcmg.2013.05.005</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/23845576">Pubmed</a> <span class="ref_v4"></span>
  • 5. Philip Haaf, Pankaj Garg, Daniel R. Messroghli, David A. Broadbent, John P. Greenwood, Sven Plein. Cardiac T1 Mapping and Extracellular Volume (ECV) in clinical practice: a comprehensive review. (2017) Journal of Cardiovascular Magnetic Resonance. 18 (1): 1. <a href="https://doi.org/10.1186/s12968-016-0308-4">doi:10.1186/s12968-016-0308-4</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/27899132">Pubmed</a> <span class="ref_v4"></span>
  • 6. Dekkers IA, Lamb HJ. Clinical application and technical considerations of T & T(*) mapping in cardiac, liver, and renal imaging. (2018) The British journal of radiology. 91 (1092): 20170825. <a href="https://doi.org/10.1259/bjr.20170825">doi:10.1259/bjr.20170825</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/29975154">Pubmed</a> <span class="ref_v4"></span>
  • 7. Schumann CL, Jaeger NR, Kramer CM. Recent Advances in Imaging of Hypertensive Heart Disease. (2019) Current hypertension reports. 21 (1): 3. <a href="https://doi.org/10.1007/s11906-019-0910-6">doi:10.1007/s11906-019-0910-6</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30637533">Pubmed</a> <span class="ref_v4"></span>
  • 8. Erik B. Schelbert, Daniel R. Messroghli. State of the Art: Clinical Applications of Cardiac T1 Mapping. (2016) Radiology. 278 (3): 658-76. <a href="https://doi.org/10.1148/radiol.2016141802">doi:10.1148/radiol.2016141802</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/26885733">Pubmed</a> <span class="ref_v4"></span>

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