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Int J Cardiovasc Imaging (2014) 30:6572 DOI 10.1007/s10554-014-0414-z
ORIGINAL PAPER
Cardiovascular magnetic resonance T2 mapping can detect myocardial edema in idiopathic dilated cardiomyopathy
Tatsuya Nishii Atsushi K. Kono Mayumi Shigeru
Sachiko Takamine Sei Fujiwara Katsusuke Kyotani
Nobukazu Aoyama Kazuro Sugimura
Received: 7 February 2014 / Accepted: 28 March 2014 / Published online: 9 April 2014 Springer Science+Business Media Dordrecht 2014
Abstract Myocardial edema and inammation play an important role in dilated cardiomyopathy (DCM). This pathologic condition can be identied noninvasively using cardiovascular magnetic resonance imaging (CMR). The purpose of this study was to determine the effectiveness of T2 values obtained with T2 mapping in the detection of edema in DCM patients, compared with that of conventional T2-weighted imaging (T2WI). CMR was used for 15 normal controls (NML) and 26 DCM patients. The DCM patients were classied as having either mild dysfunction with a left ventricular ejection fraction (EF) [35 % or severe dysfunction with an EF B35 %. Myocardial edema was assessed by both T2 mapping and T2WI. The differences between the T2 values determined from T2 mapping and the T2 ratios that were calculated from the T2WI were compared among the NML, mild DCM, and severe DCM patients. The T2 values for the NML, mild DCM, and severe DCM patients were 51.2 1.6, 61.2 0.37, and67.4 6.8, respectively (P \ 0.05 for each pair), and the corresponding T2 ratios were 1.88 0.09, 2.12 0.37, and 2.04 0.34, respectively (P [ 0.05). T2 mapping
clearly showed that the myocardial water content was larger in DCM patients than in NML controls and that the myocardial water content increased as the disease progressed. Thus, T2 mapping is a useful technique for the diagnosis and quantitation of diffuse myocardial edema.
Keywords Dilated cardiomyopathy Magnetic resonance
imaging Cardiac edema Heart failure Cardiovascular
diagnostic techniques
Introduction
Dilated cardiomyopathy (DCM) is the most common form of primary cardiomyopathy, with a natural history marked by the development of progressive heart failure and major adverse cardiac events, including sudden death [1, 2]. DCM can occur at any age but most commonly occurs in men aged 2050 years. Although the suspected causes of DCM are mostly genetic, several viral infections, toxins such as alcohol and doxorubicin, and peripartum factors are reportedly involved, but the...