Combining extracellular volume fraction imaging and T2 quantification by cardiovascular magnetic resonance in patients with clinically suspected myocarditis

Methods Short-axis T1 and T2 mapping were implemented into a standard CMR protocol at 1.5 Tesla in 36 patients with clinically suspected myocarditis. T1 quantification was performed for ECV calculation using the modified Look-Locker inversion-recovery (MOLLI) sequence before and 15 minutes after administration of 0.075 mmol/kg gadolinium BOPTA. T2 quantification was performed using a free-breathing, navigator-gated multiecho sequence. T1 and T2 maps were calculated with a dedicated plug-in written for the OsiriX software. Relaxation rates (1/T1 = R1) were calculated for myocardium and blood pool. The difference in R1 between preand post contrast media was calculated as ΔR1. Myocardial ECV was then estimated using the formula: ECV = 1-hematocrit * (ΔR1myocardium/ΔR1blood pool). Figure 1 demonstrates an example for a T2 map and T1 maps pre-/post contrast media in comparison with standard black-blood T2 STIR and late gadolinium enhancement (LGE) images.