T1 Mapping Shows Increased Extracellular Matrix Size in the Myocardium Due to Amyloid Depositions
2012; Lippincott Williams & Wilkins; Volume: 5; Issue: 3 Linguagem: Inglês
10.1161/circimaging.112.973438
ISSN1942-0080
AutoresLourens Robbers, Emma N. Baars, Wessel P. Brouwer, Aernout M. Beek, Mark B.M. Hofman, Hans W.M. Niessen, Albert C. van Rossum, C Marcu,
Tópico(s)Advanced MRI Techniques and Applications
ResumoHomeCirculation: Cardiovascular ImagingVol. 5, No. 3T1 Mapping Shows Increased Extracellular Matrix Size in the Myocardium Due to Amyloid Depositions Free AccessResearch ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissionsDownload Articles + Supplements ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toSupplementary MaterialsFree AccessResearch ArticlePDF/EPUBT1 Mapping Shows Increased Extracellular Matrix Size in the Myocardium Due to Amyloid Depositions Lourens F.H.J. Robbers, MD, MSc, Emma N. Baars, BSc, Wessel P. Brouwer, MD, Aernout M. Beek, MD, PhD, Mark B.M. Hofman, PhD, Hans W.M. Niessen, MD, PhD, Albert C. van Rossum, MD, PhD and C. Bogdan Marcu, MD Lourens F.H.J. RobbersLourens F.H.J. Robbers From the Departments of Cardiology (L.F.H.J.R., W.P.B., A.M.B., A.C.v.R., C.B.M.), Physics and Medical Technology (E.N.B., M.B.M.H.), and Pathology (H.W.M.N.), VU University Medical Center, Amsterdam, The Netherlands. , Emma N. BaarsEmma N. Baars From the Departments of Cardiology (L.F.H.J.R., W.P.B., A.M.B., A.C.v.R., C.B.M.), Physics and Medical Technology (E.N.B., M.B.M.H.), and Pathology (H.W.M.N.), VU University Medical Center, Amsterdam, The Netherlands. , Wessel P. BrouwerWessel P. Brouwer From the Departments of Cardiology (L.F.H.J.R., W.P.B., A.M.B., A.C.v.R., C.B.M.), Physics and Medical Technology (E.N.B., M.B.M.H.), and Pathology (H.W.M.N.), VU University Medical Center, Amsterdam, The Netherlands. , Aernout M. BeekAernout M. Beek From the Departments of Cardiology (L.F.H.J.R., W.P.B., A.M.B., A.C.v.R., C.B.M.), Physics and Medical Technology (E.N.B., M.B.M.H.), and Pathology (H.W.M.N.), VU University Medical Center, Amsterdam, The Netherlands. , Mark B.M. HofmanMark B.M. Hofman From the Departments of Cardiology (L.F.H.J.R., W.P.B., A.M.B., A.C.v.R., C.B.M.), Physics and Medical Technology (E.N.B., M.B.M.H.), and Pathology (H.W.M.N.), VU University Medical Center, Amsterdam, The Netherlands. , Hans W.M. NiessenHans W.M. Niessen From the Departments of Cardiology (L.F.H.J.R., W.P.B., A.M.B., A.C.v.R., C.B.M.), Physics and Medical Technology (E.N.B., M.B.M.H.), and Pathology (H.W.M.N.), VU University Medical Center, Amsterdam, The Netherlands. , Albert C. van RossumAlbert C. van Rossum From the Departments of Cardiology (L.F.H.J.R., W.P.B., A.M.B., A.C.v.R., C.B.M.), Physics and Medical Technology (E.N.B., M.B.M.H.), and Pathology (H.W.M.N.), VU University Medical Center, Amsterdam, The Netherlands. and C. Bogdan MarcuC. Bogdan Marcu From the Departments of Cardiology (L.F.H.J.R., W.P.B., A.M.B., A.C.v.R., C.B.M.), Physics and Medical Technology (E.N.B., M.B.M.H.), and Pathology (H.W.M.N.), VU University Medical Center, Amsterdam, The Netherlands. Originally published1 May 2012https://doi.org/10.1161/CIRCIMAGING.112.973438Circulation: Cardiovascular Imaging. 2012;5:423–426Amyloidosis is a systemic infiltrative disorder in which insoluble protein fibrils are deposited in the extracellular matrix (ECM). The prognosis is predominantly determined by cardiac involvement because the amyloid depositions lead to a restrictive cardiomyopathy. Although endomyocardial biopsy is the gold standard for diagnosing cardiac amyloidosis, the associated risk for complications favors a noninvasive approach by using various cardiac imaging methods, whereas tissue diagnosis is made on a noncardiac biopsy. Accurate diagnosis of cardiac amyloidosis becomes difficult when a secondary cause of myocardial wall thickening (eg, hypertension) is present as well. Cardiac MRI is an excellent tool for assessment of systolic and diastolic function, myocardial thickness, and amyloid deposition with late gadolinium enhancement imaging.1 Late gadolinium enhancement imaging is a qualitative technique, which relies on the presence of normal myocardium to visualize infiltrated, enhanced tissue. Therefore, diffuse deposition of amyloid is difficult to highlight, because regional differences in signal intensities may be absent. T1-mapping is a cardiac MR technique, which allows absolute quantification of T1 values of the myocardium and enables assessment of ECM expansion present in cardiac amyloidosis.A 71-year-old man with a medical history of hypertension presented with suspicion of congestive heart failure. A 12-lead electrocardiography showed atrial fibrillation and low voltages in the extremity leads (Figure 1). Surprisingly, echocardiography demonstrated severe concentric hypertrophy with a preserved left ventricular systolic function (Figure 2). Due to the discrepancy between hypertrophy and low voltages, cardiac amyloid was suspected and cardiac MR imaging was performed using a clinical 1.5-T scanner (Avanto; Siemens, Erlangen, Germany). Despite atrial fibrillation, images were of diagnostic quality. Functional assessment showed a left ventricular ejection fraction of 53% and wall thickness of 16 mm. Both atria were dilated and small pericardial and pleural effusions were present (online-only Data Supplement movie). To differentiate between hypertension-induced hypertrophy and increased myocardial mass due to amyloid depositions with subsequent increase in ECM, T1 mapping was performed before and at 5 and 10 minutes after 0.2 mmol/kg Gd-DOTA (Dotarem; Guerbet, Villepinte, France) contrast administration. This gadolinium-based contrast agent does not cross intact cellular membranes and distributes only in the extracellular space. T1 mapping was performed with a single short axis slice modified look-locker inversion-recovery sequence obtained during breath-holding. After T1-mapping, late gadolinium enhancement imaging was performed using an inversion recovery gradient echo sequence. Signal suppression of normal myocardial tissue was difficult (Figures 3 and 4). To assess whether the increased mass was due to an increase in ECM size or due to cellular hypertrophy, ECM size was estimated by assessing the myocardial distribution volume of Gd-DOTA. This myocardial distribution volume consists of both the extracellular, extravascular space and the tissue plasma space. This tissue plasma space fraction is in the order of 0.045 but cannot be separately assessed by MRI. T1 relaxation times were calculated for the blood pool and 6 isoangular segments of myocardium at the midventricular level (Figure 5). With the T1 relaxation times of myocardium and blood pool before and after contrast administration and correcting for hematocrit value (viz 0.37 l/L), the myocardial distribution volume was calculated.2,3 Analysis revealed a sharply increased myocardial distribution volume of Gd-DOTA in all segments (49%±5% of the myocardium; range, 44%–58%; Table) compared with previously described values of 24%±3% in normal and 34%±3% in hypertensive patients.4 These findings reinforced the suspicion of amyloidosis and subcutaneous adipose tissue biopsy was performed, confirming the diagnosis (Figure 6).Download figureDownload PowerPointFigure 1. Electrocardiography on admission showing low voltages in the extremity leads, suggestive of cardiac amyloidosis.Download figureDownload PowerPointFigure 2. Echocardiography (PSSAX) shows left ventricular hypertrophy. No evident granular sparkling of the myocardium was visible.Download figureDownload PowerPointFigure 3. Late gadolinium enhancement shows difficulties in finding the correct inversion time with inversion of the blood pool signal and the myocardium at almost similar T1 relaxation times (slice thickness 8.0 mm, time of repetition 650 ms, field of view matrix 192×186; inversion time A: 200 ms, B: 225 ms).Download figureDownload PowerPointFigure 4. Late gadolinium enhancement shows some midmyocardial patchy gadolinium enhancement in the lateral wall, likely representing more pronounced regional involvement (marked with an asterisk, inversion time 300 ms, slice thickness 8.0 mm, time of repetition 650 ms, field of view matrix 192×186).Download figureDownload PowerPointFigure 5. T1 mapping was performed on a short axis slice by calculation of the T1 relaxation times for each of the 6 equiangular segments. Segmentation was performed by using the American Heart Association standard 17-segment model. LV indicates left ventricular; IS, inferoseptum; AS, anteroseptum; AN, anterior; AL, anterolateral; IL, inferolateral; IN, inferior; N/A, not applicable.Table. T1 Relaxation Times and Calculated Volumes of Distribution of the Blood Pool and the Myocardial SegmentsLocationT1 Relaxation Time Before Gd-DOTAT1 Relaxation Time 5 Min After Gd-DOTAT1 Relaxation Time 10 Min After Gd-DOTACalculated Volume of DistributionLV blood pool1558237350N/AIS112127340048%AS109627539748%AN110527439948%AL106128941358%IL107828139946%IN107129141144%By relating the T1 relaxation times of the blood pool and the myocardium, before and after contrast administration and after blood hematocrit correction using the formula Vd(w)=(1−hematocrit)×(1/T1)myo.post−(1/T1)myo.pre(1/T1)blood.post−(1/T1)blood.pre, the myocardial volume of distribution of the extracellular agent (ie, extracellular matrix size) could be calculated, which was evidently increased.LV indicates left ventricular; IS, inferoseptum; AS, anteroseptum; AN, anterior; AL, anterolateral; IL, inferolateral; IN, inferior; N/A, not applicable.Download figureDownload PowerPointFigure 6. Congo red staining of abdominal subcutaneous adipose tissue biopsy showing red strands of amyloid fibrils among the extracellular matrix (magnification ×200).Using T1 mapping, we were able to show that myocardial amyloid deposition was not only limited to the enhanced areas on late gadolinium enhancement, but that it was a generalized process resulting in a diffuse increase in myocardial ECM volume. Figure 7 is an example of a different patient with cardiac amyloidosis. The cardiac tissue biopsy shows amyloid depositions giving rise to an increased ECM volume. T1 mapping has been used in patients with cardiac amyloidosis, although only for assessing T1 relaxation times.1 If cardiac amyloidosis is suspected and late gadolinium enhancement imaging is difficult due to diffuse infiltration, absolute quantification of myocardial distribution volume of an extracellular agent as an indication of ECM size may have additional value, especially if other causes for hypertrophy are present. Further analysis by comparison of T1 mapping and estimation of the ECM size in different pathophysiological processes causing myocardial wall thickening is necessary to assess the true applicability of this promising technique in clinical practice.Download figureDownload PowerPointFigure 7. Hematoxylin–eosin staining of cardiac tissue biopsy (different patient with cardiac amyloidosis) showing pinkish depositions (arrow) of amyloid fibrils (magnification ×100).AcknowledgmentsWe thank the patient for his cooperation in providing us with the data and images.DisclosuresDr Hofman received a research grant from Research Support Siemens, Zoetermeer, The Netherlands. Dr Niessen received research grants from The Netherlands Organisation for Scientific Research. Dr van Rossum received research grants Medtronic, Heerlen, The Netherlands; Biotronic, Nijmegen, The Netherlands; and Abbott Vascular, Hoofddorp, The Netherlands.FootnotesThe online-only Data Supplement is available with this article at http://circimaging.ahajournals.org/lookup/suppl/doi:10.1161/CIRCIMAGING.112.973438/-/DC1.Correspondence to Lourens F.H.J. Robbers, MD, MSc, Research Fellow, Cardiovascular MRI, VU Medical Center, ZH 4 D 36, PO Box 7057, 1007 MB Amsterdam, The Netherlands. E-mail l.[email protected]nlReferences1. Maceira AM, Joshi J, Prasad SK, Moon JC, Perugini E, Harding I, Sheppard MN, Poole-Wilson PA, Hawkins PN, Pennell DJ. Cardiovascular magnetic resonance in cardiac amyloidosis. Circulation. 2005; 111:186–193.LinkGoogle Scholar2. Jerosch-Herold M, Sheridan DC, Kushner JD, Nauman D, Burgess D, Dutton D, Alharethi R, Li D, Hershberger RE. 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. 2008; 295:H1234–H1242.CrossrefMedlineGoogle Scholar3. Flett AS, Hayward MP, Ashworth MT, Hansen MS, Taylor AM, Elliott PM, McGregor C, Moon JC. Equilibrium contrast cardiovascular magnetic resonance for the measurement of diffuse myocardial fibrosis: preliminary validation in humans. Circulation. 2010; 122:138–144.LinkGoogle Scholar4. Mongeon FP, Jerosch-Herold M, Coelho-Filho OR, Seabra LF, Watanabe E, Blankstein R, Kwong RY. Identification of myocardial extracellular matrix expansion by cardiac MRI in hypertensive patients. J Cardiovasc Magn Reson. 2011; 13:O109.CrossrefGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetailsCited ByPucci A, Aimo A, Musetti V, Barison A, Vergaro G, Genovesi D, Giorgetti A, Masotti S, Arzilli C, Prontera C, Pastormerlo L, Coceani M, Ciardetti M, Martini N, Palmieri C, Passino C, Rapezzi C and Emdin M (2021) Amyloid Deposits and Fibrosis on Left Ventricular Endomyocardial Biopsy Correlate With Extracellular Volume in Cardiac Amyloidosis, Journal of the American Heart Association, 10:20, Online publication date: 19-Oct-2021. Kim J, Hong Y, Han K, Lee H, Hur J, Kim Y and Choi B (2021) Regional Amyloid Burden Differences Evaluated Using Quantitative Cardiac MRI in Patients with Cardiac Amyloidosis, Korean Journal of Radiology, 10.3348/kjr.2020.0579, 22:6, (880), . Son J and Hong Y (2021) Treatment Response Evaluation of Cardiac Amyloidosis Using Serial T1- and T2-Mapping Cardiovascular Magnetic Resonance Imaging, Journal of the Korean Society of Radiology, 10.3348/jksr.2020.0048, 82:2, (429), . Adams L, Jurmeister P, Ralla B, Bressem K, Fahlenkamp U, Engel G, Siepmann S, Wagner M, Hamm B, Busch J and Makowski M (2019) Assessment of the extracellular volume fraction for the grading of clear cell renal cell carcinoma: first results and histopathological findings, European Radiology, 10.1007/s00330-019-06087-x, 29:11, (5832-5843), Online publication date: 1-Nov-2019. Adams L, Ralla B, Jurmeister P, Bressem K, Fahlenkamp U, Hamm B, Busch J and Makowski M (2019) Native T1 Mapping as an In Vivo Biomarker for the Identification of Higher-Grade Renal Cell Carcinoma, Investigative Radiology, 10.1097/RLI.0000000000000515, 54:2, (118-128), Online publication date: 1-Feb-2019. Nam B, Kim S, Jung H, Kim Y and Choe Y (2018) Comparison of quantitative imaging parameters using cardiovascular magnetic resonance between cardiac amyloidosis and hypertrophic cardiomyopathy: inversion time scout versus T1 mapping, The International Journal of Cardiovascular Imaging, 10.1007/s10554-018-1385-2, 34:11, (1769-1777), Online publication date: 1-Nov-2018. Morgan R, Jerosch-Herold M and Kwong R (2018) Comparison of T1 Mapping by Cardiac MRI to Non-cardiac MRI Methods to Evaluate Cardiac Fibrosis T1-Mapping in Myocardial Disease, 10.1007/978-3-319-91110-6_4, (45-59), . Mavrogeni S, Koutsogeorgopoulou L, Markousis-Mavrogenis G, Bounas A, Tektonidou M, Lliossis S, Daoussis D, Plastiras S, Karabela G, Stavropoulos E, Katsifis G, Vartela V and Kolovou G (2017) Cardiovascular magnetic resonance detects silent heart disease missed by echocardiography in systemic lupus erythematosus, Lupus, 10.1177/0961203317731533, 27:4, (564-571), Online publication date: 1-Apr-2018. Salerno M and Kramer C (2018) T1 Mapping in Cardiac Hypertrophy T1-Mapping in Myocardial Disease, 10.1007/978-3-319-91110-6_2, (15-25), . Mavrogeni S, Markousis-Mavrogenis G, Koutsogeorgopoulou L, Dimitroulas T, Bratis K, Kitas G, Sfikakis P, Tektonidou M, Karabela G, Stavropoulos E, Katsifis G, Boki K, Kitsiou A, Filaditaki V, Gialafos E, Plastiras S, Vartela V and Kolovou G (2017) Cardiovascular magnetic resonance imaging pattern at the time of diagnosis of treatment naïve patients with connective tissue diseases, International Journal of Cardiology, 10.1016/j.ijcard.2017.01.104, 236, (151-156), Online publication date: 1-Jun-2017. Shukla A, Wong D, Humphries J, Fitzgerald B, Newbigin K, Bashford J and Scalia G (2017) Transthyretin Cardiac Amyloidosis: A Noninvasive Multimodality Approach to Diagnosis Using Transthoracic Echocardiography, 99m-Tc-Labeled Phosphate Bone Scanning, and Cardiac Magnetic Resonance Imaging, CASE, 10.1016/j.case.2017.01.012, 1:2, (49-53), Online publication date: 1-Apr-2017. Choi E, Park C and Kim T (2017) The Prognostic Role of T1 Mapping Sequences: Can T1 Mapping Parameters Have a Role in Risk Stratification?, Cardiovascular Imaging Asia, 10.22468/cvia.2017.00073, 1:3, (193), . Martinez-Naharro A, Treibel T, Abdel-Gadir A, Bulluck H, Zumbo G, Knight D, Kotecha T, Francis R, Hutt D, Rezk T, Rosmini S, Quarta C, Whelan C, Kellman P, Gillmore J, Moon J, Hawkins P and Fontana M (2017) Magnetic Resonance in Transthyretin Cardiac Amyloidosis, Journal of the American College of Cardiology, 10.1016/j.jacc.2017.05.053, 70:4, (466-477), Online publication date: 1-Jul-2017. Nickander J, Lundin M, Abdula G, Sörensson P, Rosmini S, Moon J, Kellman P, Sigfridsson A and Ugander M (2017) Blood correction reduces variability and gender differences in native myocardial T1 values at 1.5 T cardiovascular magnetic resonance – a derivation/validation approach, Journal of Cardiovascular Magnetic Resonance, 10.1186/s12968-017-0353-7, 19:1, Online publication date: 1-Dec-2017. Morgan R and Kwong R (2017) CMR in Phenotyping the Arrhythmic Substrate, Current Cardiovascular Imaging Reports, 10.1007/s12410-017-9416-2, 10:6, Online publication date: 1-Jun-2017. Saeed M, Liu H, Liang C and Wilson M (2017) Magnetic resonance imaging for characterizing myocardial diseases, The International Journal of Cardiovascular Imaging, 10.1007/s10554-017-1127-x, 33:9, (1395-1414), Online publication date: 1-Sep-2017. Gallego-Delgado M, González-López E, Muñoz-Beamud F, Buades J, Galán L, Muñoz-Blanco J, Sánchez-González J, Ibáñez B, Mirelis J and García-Pavía P (2016) Extracellular Volume Detects Amyloidotic Cardiomyopathy and Correlates With Neurological Impairment in Transthyretin-familial Amyloidosis, Revista Española de Cardiología (English Edition), 10.1016/j.rec.2016.02.027, 69:10, (923-930), Online publication date: 1-Oct-2016. Schelbert E and Messroghli D (2016) State of the Art: Clinical Applications of Cardiac T1 Mapping, Radiology, 10.1148/radiol.2016141802, 278:3, (658-676), Online publication date: 1-Mar-2016. Gallego-Delgado M, González-López E, Muñoz-Beamud F, Buades J, Galán L, Muñoz-Blanco J, Sánchez-González J, Ibáñez B, Mirelis J and García-Pavía P (2016) El volumen extracelular detecta la amiloidosis cardiaca y está correlacionado con el deterioro neurológico en la amiloidosis familiar relacionada con la transtiretina, Revista Española de Cardiología, 10.1016/j.recesp.2016.02.032, 69:10, (923-930), Online publication date: 1-Oct-2016. Banypersad S, Fontana M, Maestrini V, Sado D, Captur G, Petrie A, Piechnik S, Whelan C, Herrey A, Gillmore J, Lachmann H, Wechalekar A, Hawkins P and Moon J (2014) T1 mapping and survival in systemic light-chain amyloidosis, European Heart Journal, 10.1093/eurheartj/ehu444, 36:4, (244-251), Online publication date: 2-Jan-2015. Tessa C, Diciotti S, Landini N, Lilli A, Del Meglio J, Salvatori L, Giannelli M, Greiser A, Vignali C and Casolo G (2015) Myocardial T1 and T2 mapping in diastolic and systolic phase, The International Journal of Cardiovascular Imaging, 10.1007/s10554-015-0639-5, 31:5, (1001-1010), Online publication date: 1-Jun-2015. Pattanayak P and Bleumke D (2015) Tissue Characterization of the Myocardium, Radiologic Clinics of North America, 10.1016/j.rcl.2014.11.005, 53:2, (413-423), Online publication date: 1-Mar-2015. Kim T, Jung J, Kim Y, Kim H and Lee H (2015) CT and MRI evaluation of cardiac complications in patients with hematologic diseases: a pictorial review, The International Journal of Cardiovascular Imaging, 10.1007/s10554-015-0610-5, 31:S2, (159-167), Online publication date: 1-Dec-2015. van Oorschot J, Gho J, van Hout G, Froeling M, Jansen of Lorkeers S, Hoefer I, Doevendans P, Luijten P, Chamuleau S and Zwanenburg J (2014) Endogenous contrast MRI of cardiac fibrosis: Beyond late gadolinium enhancement, Journal of Magnetic Resonance Imaging, 10.1002/jmri.24715, 41:5, (1181-1189), Online publication date: 1-May-2015. Schelbert E and Wong T (2015) Adding T1 Mapping and Extracellular Volume Fraction for Myocardial Fibrosis Assessment: Implications for Cardiovascular Risk Assessment Molecular and Multimodality Imaging in Cardiovascular Disease, 10.1007/978-3-319-19611-4_7, (137-151), . Gertz M and Zeldenrust S (2014) Amyloidosis Multiple Myeloma, 10.1007/978-1-4614-8520-9_22, (265-282), . Mavrogeni S, Sfikakis P, Gialafos E, Bratis K, Karabela G, Stavropoulos E, Spiliotis G, Sfendouraki E, Panopoulos S, Bournia V, Kolovou G and Kitas G (2013) Cardiac Tissue Characterization and the Diagnostic Value of Cardiovascular Magnetic Resonance in Systemic Connective Tissue Diseases, Arthritis Care & Research, 10.1002/acr.22181, 66:1, (104-112), Online publication date: 1-Jan-2014. de Graaf W, Vandoorne K, Arslan F, Nicolay K and Strijkers G (2014) Contrast-Enhanced T1-Mapping MRI for the Assessment of Myocardial Fibrosis, Current Cardiovascular Imaging Reports, 10.1007/s12410-014-9260-6, 7:4, Online publication date: 1-Apr-2014. Higgins D and Moon J (2014) Review of T1 Mapping Methods: Comparative Effectiveness Including Reproducibility Issues, Current Cardiovascular Imaging Reports, 10.1007/s12410-013-9252-y, 7:3, Online publication date: 1-Mar-2014. Roubille F, Busseuil D, Merlet N, Kritikou E, Rhéaume E and Tardif J (2013) Investigational drugs targeting cardiac fibrosis, Expert Review of Cardiovascular Therapy, 10.1586/14779072.2013.839942, 12:1, (111-125), Online publication date: 1-Jan-2014. Karamitsos T, Piechnik S, Banypersad S, Fontana M, Ntusi N, Ferreira V, Whelan C, Myerson S, Robson M, Hawkins P, Neubauer S and Moon J (2013) Noncontrast T1 Mapping for the Diagnosis of Cardiac Amyloidosis, JACC: Cardiovascular Imaging, 10.1016/j.jcmg.2012.11.013, 6:4, (488-497), Online publication date: 1-Apr-2013. Bauner K and Wintersperger B (2012) MRT bei kardialer Sarkoidose und AmyloidoseMRI in cardiac sarcoidosis and amyloidosis, Der Radiologe, 10.1007/s00117-012-2386-0, 53:1, (54-60), Online publication date: 1-Jan-2013. Lu M, Zhao S, Yin G, Jiang S, Zhao T, Chen X, Tian L, Zhang Y, Wei Y, Liu Q, He Z, Xue H, An J and Shah S (2013) T1 mapping for detection of left ventricular myocardial fibrosis in hypertrophic cardiomyopathy: A preliminary study, European Journal of Radiology, 10.1016/j.ejrad.2012.12.014, 82:5, (e225-e231), Online publication date: 1-May-2013. Brooks J, Kramer C and Salerno M (2013) Markedly increased volume of distribution of gadolinium in cardiac amyloidosis demonstrated by T 1 mapping , Journal of Magnetic Resonance Imaging, 10.1002/jmri.24078, 38:6, (1591-1595), Online publication date: 1-Dec-2013. Won S, Davies-Venn C, Liu S and Bluemke D (2013) Noninvasive imaging of myocardial extracellular matrix for assessment of fibrosis, Current Opinion in Cardiology, 10.1097/HCO.0b013e32835f5a2b, 28:3, (282-289), Online publication date: 1-May-2013. Liu S, Han J, Nacif M, Jones J, Kawel N, Kellman P, Sibley C and Bluemke D (2012) Diffuse myocardial fibrosis evaluation using cardiac magnetic resonance T1 mapping: sample size considerations for clinical trials, Journal of Cardiovascular Magnetic Resonance, 10.1186/1532-429X-14-90, 14:1, Online publication date: 1-Dec-2012. Keller S, Borde T, Brangsch J, Adams L, Kader A, Reimann C, Gebert P, Hamm B and Makowski M (2020) Native T1 Mapping Magnetic Resonance Imaging as a Quantitative Biomarker for Characterization of the Extracellular Matrix in a Rabbit Hepatic Cancer Model, Biomedicines, 10.3390/biomedicines8100412, 8:10, (412) Scalise R, De Sarro R, Caracciolo A, Lauro R, Squadrito F, Carerj S, Bitto A, Micari A, Bella G, Costa F and Irrera N (2021) Fibrosis after Myocardial Infarction: An Overview on Cellular Processes, Molecular Pathways, Clinical Evaluation and Prognostic Value, Medical Sciences, 10.3390/medsci9010016, 9:1, (16) Jean L, Foley A and Vaux D (2017) The Physiological and Pathological Implications of the Formation of Hydrogels, with a Specific Focus on Amyloid Polypeptides, Biomolecules, 10.3390/biom7040070, 7:4, (70) May 2012Vol 5, Issue 3 Advertisement Article InformationMetrics © 2012 American Heart Association, Inc.https://doi.org/10.1161/CIRCIMAGING.112.973438PMID: 22592012 Manuscript receivedMarch 7, 2012Manuscript acceptedMarch 12, 2012Originally publishedMay 1, 2012 KeywordsT1 mappingmagnetic resonance imagingtissue characterizationamyloidpathologyPDF download Advertisement SubjectsCardiomyopathyComputerized Tomography (CT)Congenital Heart Disease
Referência(s)