Subscribe to RSS
Role of Cardiac MRI Including LGE, T1 and T2 Mapping in the Assessment of Cardiac Involvement in Patients of Nonspecific Aorto-arteritis: A Prospective StudyFunding None.
Objective Nonspecific aorto-arteritis (NSAA) may involve the myocardium in the form of edema and fibrosis. We conducted this study to investigate role of cardiac MRI including late gadolinium enhancement (LGE), T1 and T2 mapping in the assessment of cardiac involvement in NSAA.
Methods and Materials Over the period between 2016 and 2019, 36 patients with NSAA presenting with uncontrolled hypertension, left ventricular dysfunction, congestive cardiac failure, or tachyarrhythmia were included in the study. We also had 16 voluntary control patients for providing normal T1 and T2 mapping values.
Results The average age of patients was 27.1 years and the majority were females. MRI is more sensitive than echocardiography in the detection of LV dysfunction and RWMA. Out of 36 patients, 10 (27.8%) had LGE. The most common pattern of midmyocardial enhancement was present in 5 out of 10 patients. Five (13.8%) patients show mid-myocardial enhancement, followed by epicardial enhancement, which was seen in four (11.11%) patients. The values of post-gad T1 mapping values were significantly lower than pre-gad T1 mapping values. At a cut-off global native T1 mapping value of 1019 milliseconds had the sensitivity of 83.3% and specificity of 81.2% in detecting an abnormal T1 map. No significant association of MRI contrast enhancement with elevated ESR and CRP levels. There was no significant relation of myocardial T2 mapping values between NSAA and control groups.
Conclusion Quantitative tissue characterization in the myocardium with native T1 mapping values help in the detection of cardiac involvement in patients with NSAA. T1 mapping may provide incremental value in the assessment of myocardial involvement in NSAA in addition to LGE imaging.
Article published online:
30 August 2022
© 2022. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
- 1 Isobe M. Takayasu arteritis revisited: current diagnosis and treatment. Int J Cardiol 2013; 168 (01) 3-10
- 2 Sharma BK, Jain S, Suri S, Numano F. Diagnostic criteria for Takayasu arteritis. Int J Cardiol 1996; 54 (Suppl): S141-S147
- 3 Talwar KK, Chopra P, Narula J. et al. Myocardial involvement and its response to immunosuppressive therapy in nonspecific aortoarteritis (Takayasu's disease)–a study by endomyocardial biopsy. Int J Cardiol 1988; 21 (03) 323-334
- 4 Talwar KK, Kumar K, Chopra P. et al. Cardiac involvement in nonspecific aortoarteritis (Takayasu's arteritis). Am Heart J 1991; 122 (06) 1666-1670
- 5 Burt JR, Zimmerman SL, Kamel IR, Halushka M, Bluemke DA. Myocardial T1 mapping: techniques and potential applications. Radiographics 2014; 34 (02) 377-395
- 6 Mathew AJ, Goel R, Kumar S, Danda D. Childhood-onset Takayasu arteritis: an update. Int J Rheum Dis 2016; 19 (02) 116-126
- 7 Soto ME, Espinola-Zavaleta N, Ramirez-Quito O, Reyes PA. Echocardiographic follow-up of patients with Takayasu's arteritis: five-year survival. Echocardiography 2006; 23 (05) 353-360
- 8 Pan JA, Lee YJ, Salerno M. Diagnostic performance of extracellular volume, native T1, and T2 mapping versus Lake Louise Criteria by cardiac magnetic resonance for detection of acute myocarditis: a meta-analysis. Circ Cardiovasc Imaging 2018; 11 (07) e007598
- 9 Greulich S, Mayr A, Kitterer D. et al. T1 and T2 mapping for evaluation of myocardial involvement in patients with ANCA-associated vasculitides. J Cardiovasc Magn Reson 2017; 19 (01) 6 DOI: 10.1186/s12968-016-0315-5.
- 10 Keenan NG, Mason JC, Maceira A. et al. Integrated cardiac and vascular assessment in Takayasu arteritis by cardiovascular magnetic resonance. Arthritis Rheum 2009; 60 (11) 3501-3509
- 11 Eshet Y, Pauzner R, Goitein O. et al. The limited role of MRI in long-term follow-up of patients with Takayasu's arteritis. Autoimmun Rev 2011; 11 (02) 132-136
- 12 John R, Shyamkumar NK, Danda D. MRI assessment of disease activity in Takayasu arteritis. Indian J Rheumatol 2011; 6 (03) S16
- 13 Jiang L, Li D, Yan F, Dai X, Li Y, Ma L. Evaluation of Takayasu arteritis activity by delayed contrast-enhanced magnetic resonance imaging. Int J Cardiol 2012; 155 (02) 262-267
- 14 Papa M, De Cobelli F, Baldissera E. et al. Takayasu arteritis: intravascular contrast medium for MR angiography in the evaluation of disease activity. Am J Roentgenol 2012; 198 (03) W279-84