Wild-type (senile) amyloidosis MRI
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]
Overview
T1 sequence of CMR with the use of gadolinium can differentiate extracellular tissue thickening due to myocardial hypertrophy vs. extracellular deposition. Using pre- and post-contrast T1 mapping, extracellular volume (ECV) can be calculated, which is a direct measurement of the cardiac interstitium. ECV expansion is a quantitative marker of the amyloid burden and can detect amyloid fibrils infiltration earlier than conventional testing. One of the benefits of T1 mapping is the fact that it does not require contrast, which is favorable in the setting of kidney disease.
MRI
Cardiovascular Magnetic Resonance (CMR)
- T1 sequence of CMR with the use of gadolinium can differentiate extracellular tissue thickening due to myocardial hypertrophy vs. extracellular deposition.
- Using pre- and post-contrast T1 mapping, extracellular volume (ECV) can be calculated, which is a direct measurement of the cardiac interstitium.[1]
- ECV expansion is a quantitative marker of the amyloid burden and can detect amyloid fibrils infiltration earlier than conventional testing.[2][3]
- Increased non-contrast T1 relaxation times are also seen in patients.[4][5]
- One of the benefits of T1 mapping is the fact that it does not require contrast, which is favorable in the setting of kidney disease.[6][7]
- Early stages of the disease correspond to negative late gadolinium enhancement (LGE).[8][9]
- Late stages of the disease are characterized by subendocardial and transmural LGE, which also aligns with increasing ECV and worse prognosis.
References
- ↑ Francois-Pierre Mongeon, Michael Jerosch-Herold, Otavio Rizzi Coelho-Filho, Ron Blankstein, Rodney H. Falk & Raymond Y. Kwong (2012). "Quantification of extracellular matrix expansion by CMR in infiltrative heart disease". JACC. Cardiovascular imaging. 5 (9): 897–907. doi:10.1016/j.jcmg.2012.04.006. PMID 22974802. Unknown parameter
|month=ignored (help) - ↑ Ana Martinez-Naharro, Thomas A. Treibel, Amna Abdel-Gadir, Heerajnarain Bulluck, Giulia Zumbo, Daniel S. Knight, Tushar Kotecha, Rohin Francis, David F. Hutt, Tamer Rezk, Stefania Rosmini, Candida C. Quarta, Carol J. Whelan, Peter Kellman, Julian D. Gillmore, James C. Moon, Philip N. Hawkins & Marianna Fontana (2017). "Magnetic Resonance in Transthyretin Cardiac Amyloidosis". Journal of the American College of Cardiology. 70 (4): 466–477. doi:10.1016/j.jacc.2017.05.053. PMID 28728692. Unknown parameter
|month=ignored (help) - ↑ Sanjay M. Banypersad, Marianna Fontana, Viviana Maestrini, Daniel M. Sado, Gabriella Captur, Aviva Petrie, Stefan K. Piechnik, Carol J. Whelan, Anna S. Herrey, Julian D. Gillmore, Helen J. Lachmann, Ashutosh D. Wechalekar, Philip N. Hawkins & James C. Moon (2015). "T1 mapping and survival in systemic light-chain amyloidosis". European heart journal. 36 (4): 244–251. doi:10.1093/eurheartj/ehu444. PMID 25411195. Unknown parameter
|month=ignored (help) - ↑ Sanjay M. Banypersad, Daniel M. Sado, Andrew S. Flett, Simon D. J. Gibbs, Jennifer H. Pinney, Viviana Maestrini, Andrew T. Cox, Marianna Fontana, Carol J. Whelan, Ashutosh D. Wechalekar, Philip N. Hawkins & James C. Moon (2013). "Quantification of myocardial extracellular volume fraction in systemic AL amyloidosis: an equilibrium contrast cardiovascular magnetic resonance study". Circulation. Cardiovascular imaging. 6 (1): 34–39. doi:10.1161/CIRCIMAGING.112.978627. PMID 23192846. Unknown parameter
|month=ignored (help) - ↑ Theodoros D. Karamitsos, Stefan K. Piechnik, Sanjay M. Banypersad, Marianna Fontana, Ntobeko B. Ntusi, Vanessa M. Ferreira, Carol J. Whelan, Saul G. Myerson, Matthew D. Robson, Philip N. Hawkins, Stefan Neubauer & James C. Moon (2013). "Noncontrast T1 mapping for the diagnosis of cardiac amyloidosis". JACC. Cardiovascular imaging. 6 (4): 488–497. doi:10.1016/j.jcmg.2012.11.013. PMID 23498672. Unknown parameter
|month=ignored (help) - ↑ Marianna Fontana, Robin Chung, Philip N. Hawkins & James C. Moon (2015). "Cardiovascular magnetic resonance for amyloidosis". Heart failure reviews. 20 (2): 133–144. doi:10.1007/s10741-014-9470-7. PMID 25549885. Unknown parameter
|month=ignored (help) - ↑ Marianna Fontana, Silvia Pica, Patricia Reant, Amna Abdel-Gadir, Thomas A. Treibel, Sanjay M. Banypersad, Viviana Maestrini, William Barcella, Stefania Rosmini, Heerajnarain Bulluck, Rabya H. Sayed, Ketna Patel, Shameem Mamhood, Chiara Bucciarelli-Ducci, Carol J. Whelan, Anna S. Herrey, Helen J. Lachmann, Ashutosh D. Wechalekar, Charlotte H. Manisty, Eric B. Schelbert, Peter Kellman, Julian D. Gillmore, Philip N. Hawkins & James C. Moon (2015). "Prognostic Value of Late Gadolinium Enhancement Cardiovascular Magnetic Resonance in Cardiac Amyloidosis". Circulation. 132 (16): 1570–1579. doi:10.1161/CIRCULATIONAHA.115.016567. PMID 26362631. Unknown parameter
|month=ignored (help) - ↑ Marianna Fontana, Silvia Pica, Patricia Reant, Amna Abdel-Gadir, Thomas A. Treibel, Sanjay M. Banypersad, Viviana Maestrini, William Barcella, Stefania Rosmini, Heerajnarain Bulluck, Rabya H. Sayed, Ketna Patel, Shameem Mamhood, Chiara Bucciarelli-Ducci, Carol J. Whelan, Anna S. Herrey, Helen J. Lachmann, Ashutosh D. Wechalekar, Charlotte H. Manisty, Eric B. Schelbert, Peter Kellman, Julian D. Gillmore, Philip N. Hawkins & James C. Moon (2015). "Prognostic Value of Late Gadolinium Enhancement Cardiovascular Magnetic Resonance in Cardiac Amyloidosis". Circulation. 132 (16): 1570–1579. doi:10.1161/CIRCULATIONAHA.115.016567. PMID 26362631. Unknown parameter
|month=ignored (help) - ↑ James A. White, Han W. Kim, Dipan Shah, Nowell Fine, Ki-Young Kim, David C. Wendell, Wael Al-Jaroudi, Michele Parker, Manesh Patel, Femida Gwadry-Sridhar, Robert M. Judd & Raymond J. Kim (2014). "CMR imaging with rapid visual T1 assessment predicts mortality in patients suspected of cardiac amyloidosis". JACC. Cardiovascular imaging. 7 (2): 143–156. doi:10.1016/j.jcmg.2013.09.019. PMID 24412191. Unknown parameter
|month=ignored (help)