Markedly increased volume of distribution of gadolinium in cardiac amyloidosis demonstrated by T1 mapping. Issue 6 (28th February 2013)

• Record Type: Journal Article
• Authors: Brooks, Jeremy; Kramer, Christopher M.; Salerno, Michael
• Is Part Of: Journal of magnetic resonance imaging. Volume 38:Issue 6(2013)
• Page Start: 1591
• Page End: 1595
• Publication Date: 2013-02-28
• Subjects: Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.24078
• Languages: English
• ISSNs: 1053-1807

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jmri24078-sec-0001" sec-type="section"> <title>Purpose</title> <p>To perform myocardial T<sub>1</sub> mapping pre‐ and post‐gadolinium (Gd) administration and determine the volume of distribution of Gd (Vd<sub>Gd</sub>) in patients with cardiac amyloidosis to assess extracellular space expansion from amyloid protein deposition.</p> </sec> <sec id="jmri24078-sec-0002" sec-type="section"> <title>Materials and Methods</title> <p>T<sub>1</sub> mapping was performed before contrast and 20 minutes following bolus administration of 0.15 mmol/kg of gadopentetate dimeglumine (Magnevist) in five subjects with cardiac amyloidosis and in eight healthy volunteers using previously validated 3–5 Modified Look‐Locker Inversion (MOLLI) pulse sequence. The partition coefficient (λ) and Vd<sub>Gd</sub> were determined and compared between groups.</p> </sec> <sec id="jmri24078-sec-0003" sec-type="section"> <title>Results</title> <p>Before contrast the T<sub>1</sub> of the blood and myocardium are longer in amyloidosis as compared to controls (1665 vs. 1509 msec; <italic>P</italic> = 0.03 and 1144 vs. 963 msec; <italic>P</italic> < 0.001, respectively). Postcontrast blood T<sub>1</sub> was also significantly longer in amyloidosis (486 vs. 408 msec; <italic>P</italic> = 0.003) with a trend towards shorter T<sub>1</sub> in the myocardium (503 vs. 544 msec; <italic>P</italic> = 0.15). The Vd<sub>Gd</sub> was 83% higher in amyloidosis than in controls (0.51 vs. 0.28; <italic>P</italic> = 0.005).</p> </sec> <sec id="jmri24078-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Myocardial Vd<sub>Gd</sub> is markedly increased in cardiac amyloidosis, reflecting the increased extracellular space occupied by amyloid proteins. The precontrast T<sub>1</sub> of blood and myocardium are increased in amyloidosis extending diagnostic utility in patients who cannot receive Gd. J. Magn. Reson. Imaging 2013;38:1591–1595. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>