Role of cardiac T1 mapping and extracellular volume in the assessment of myocardial infarction

Özet

Although late gadolinium enhancement on cardiac magnetic resonance imaging remains the reference standard for scar assessment, it doesnot provide quantitative information about the extent of pathophysiological changes within the scar tissue. T1 mapping and extracellular volume(ECV) mapping are steadily becoming diagnostic and prognostically useful tests for in vivo myocardial histology, influencing clinical decisionmaking.Quantitative native T1 maps (acquired without a contrast agent) represent the longitudinal relaxation time within the myocardium andchanges with myocardial extracellular water (edema, focal, or diffuse fibrosis), fat, iron, and amyloid protein content. Post-contrast ECV mapsestimate the size of the extracellular space and have sensitivity in the identification of interstitial disease. Both pre- and post-contrast T1 mappingare emerging as comprehensive tools for the assessment of numerous conditions including ischemic scarring that occurs post myocardialinfarction (MI). This review outlines the current evidence and potential future role of T1 mapping in MI. We conclude by highlighting some of theremaining challenges such as quality control, standardization of image acquisition for clinical practice, and automated methods for quantifyinginfarct size, area at risk, and myocardial salvage post MI.