Role of Cardiac MRI Including LGE, T1 and T2 Mapping in the Assessment of Cardiac Involvement in Patients of Nonspecific Aorto-arteritis: A Prospective Study

S H. Chandrashekhara; Gurpreet Singh Gulati; Sanjiv Sharma; Sanjeev Kumar; Shiv Kumar Chaudhary; Priya Jagia; Sandeep Seth; Saurabh Kumar Gupta; Mahroof Khan

doi:10.1055/s-0042-1754362

Indian Journal of Radiology and Imaging, Table of Contents

CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2022; 32(04): 441-450
DOI: 10.1055/s-0042-1754362

Original Article

Role of Cardiac MRI Including LGE, T1 and T2 Mapping in the Assessment of Cardiac Involvement in Patients of Nonspecific Aorto-arteritis: A Prospective Study

S H. Chandrashekhara

¹Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India

,

Gurpreet Singh Gulati

¹Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India

,

Sanjiv Sharma

¹Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India

,

Sanjeev Kumar

¹Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India

,

Shiv Kumar Chaudhary

²Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India

,

Priya Jagia

¹Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India

,

Sandeep Seth

³Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India

,

Saurabh Kumar Gupta

³Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India

,

Mahroof Khan

⁴Department of Biostatastics, All India Institute of Medical Sciences, New Delhi, India

› Author Affiliations

Abstract

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.

Keywords

cardiac MRI - nonspecific aorto-arteritis - T1 mapping - T2 mapping

Full Text

References

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