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Markedly increased volume of distribution of gadolinium in cardiac amyloidosis demonstrated by T 1 mapping
Author(s) -
Brooks Jeremy,
Kramer Christopher M.,
Salerno Michael
Publication year - 2013
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24078
Subject(s) - amyloidosis , cardiac amyloidosis , medicine , al amyloidosis , gadolinium , bolus (digestion) , nuclear medicine , extracellular , extracellular fluid , cardiology , pathology , chemistry , immunoglobulin light chain , biochemistry , organic chemistry , antibody , immunology
Purpose To perform myocardial T 1 mapping pre‐ and post‐gadolinium (Gd) administration and determine the volume of distribution of Gd (Vd Gd ) in patients with cardiac amyloidosis to assess extracellular space expansion from amyloid protein deposition. Materials and Methods T 1 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 Gd were determined and compared between groups. Results Before contrast the T 1 of the blood and myocardium are longer in amyloidosis as compared to controls (1665 vs. 1509 msec; P = 0.03 and 1144 vs. 963 msec; P < 0.001, respectively). Postcontrast blood T 1 was also significantly longer in amyloidosis (486 vs. 408 msec; P = 0.003) with a trend towards shorter T 1 in the myocardium (503 vs. 544 msec; P = 0.15). The Vd Gd was 83% higher in amyloidosis than in controls (0.51 vs. 0.28; P = 0.005). Conclusion Myocardial Vd Gd is markedly increased in cardiac amyloidosis, reflecting the increased extracellular space occupied by amyloid proteins. The precontrast T 1 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.