Nemzeti szívprogram(NVKP_16-1–2016-0017) Támogató: NKFIH
Cardiovascular magnetic resonance imaging is one of the most important diagnostic
modalities in the evaluation of cardiomyopathies. However, significant limitations
are the complex and time-consuming workflows and the need of contrast agents. The
aim of this multi-center retrospective study was to assess workflows and diagnostic
value of a short, contrast agent-free cardiac magnetic resonance protocol. 160 patients
from Heidelberg, Germany and 119 patients from Montreal, Canada with suspected cardiomyopathy
and 20 healthy volunteers have been enrolled. Scans were performed at a 1.5Tesla or
3Tesla scanner in Heidelberg and at a 3Tesla scanner in Montreal. We used single-slice
T1 map only. A stepwise analysis of images has been performed. The possible differential
diagnosis after each step has been defined. T1-values and color-encoded T1 maps significantly
contributed to the differential diagnosis in 54% of the cases (161/299); the final
diagnosis has been done without late gadolinium enhancement images in 83% of healthy
individuals, in 99% of patients with dilated cardiomyopathy, in 93% of amyloidosis
patients, in 94% of patients with hypertrophic cardiomyopathy and in 85% of patients
with hypertensive heart disease, respectively. Comparing the scan time with (48 +/-
7 min) vs. without contrast agent (23 +/- 5 min), significant time saving could be
reached by the short protocol. Subgroup analysis showed the most additional diagnostic
value of T1 maps in amyloidosis and hypertrophic cardiomyopathy or in confirmation
of normal findings. In patients with unclear left ventricular hypertrophy, a short,
non-contrast protocol can be used for diagnostic decision-making, if the quality of
the T1 map is diagnostic, even if only one slice is available.
