Diagnostic value of native T1 Mapping in patients with cardiac amyloidosis
DOI:
https://doi.org/10.53903/01212095.414Keywords:
Amyloidosis, Cardiac magnetic resonance imaging, Diagnostic imaging, CardiomyopathiesAbstract
Introduction: Amyloidosis with cardiac involvement is often underdiagnosed and has a high mortality rate. Cardiac magnetic resonance imaging (MRI) with native T1 Mapping (without IV contrast) could serve as an early marker of the disease, but its diagnostic accuracy in our setting is unknown. Objectives: To determine the diagnostic value of native T1 Mapping in patients with cardiac light chain (AL) amyloidosis. Methods: Evaluation of Cardiac MRI as a diagnostc test in 8 patients with light chain amyloidosis (AL) with cardiac involvement and 18 healthy individuals.
All patients underwent 3T (Tesla) CMR with native T1 Mapping sequence (MOLLI, Modified Look- Locker Inversion-recovery) and longitudinal and short-axis cine images. The T1 mapping mean with 95 % CI was estimated and sensitivity and specificity were calculated. Inter and intra-observer agreement was evaluated. Results: Patients with AL amyloidosis demonstrated increased values of Native T1 Mapping compared to healthy ones (1,415 ms ± 69 vs. 1,214 ms ± 44; p <0.001). The value of the native T1 Mapping in patients with AL amyloidosis varied between 1,322 and 1,493 ms while in the healthy it varied between 1,098 and 1,285 ms. A native T1 Mapping value greater than 1,357 ms (3.25 standard deviations) achieves a sensitivity (S) of 87.5 %, a specificity (E) of 100 %, and an accuracy in the classification of sick or healthy of 96.2 %. Conclusions: The native T1 Mapping CMR has adequate diagnostic performance and is a sensitive and specific tool for identifying patients with AL cardiac amyloidosis.
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