Korean J Radiol.  2017 Feb;18(1):113-131. 10.3348/kjr.2017.18.1.113.

Myocardial T1 and T2 Mapping: Techniques and Clinical Applications

• Kim PK
• Hong YJ
• Im DJ
• Suh YJ
• Park CH
• Kim JY
• Chang S
• Lee HJ
• Hur J
• Kim YJ
• Choi BW

• KMID: 2468127
• DOI: http://doi.org/10.3348/kjr.2017.18.1.113

Abstract

Cardiac magnetic resonance (CMR) imaging is widely used in various medical fields related to cardiovascular diseases. Rapid technological innovations in magnetic resonance imaging in recent times have resulted in the development of new techniques for CMR imaging. T1 and T2 image mapping sequences enable the direct quantification of T1, T2, and extracellular volume fraction (ECV) values of the myocardium, leading to the progressive integration of these sequences into routine CMR settings. Currently, T1, T2, and ECV values are being recognized as not only robust biomarkers for diagnosis of cardiomyopathies, but also predictive factors for treatment monitoring and prognosis. In this study, we have reviewed various T1 and T2 mapping sequence techniques and their clinical applications.

Keyword

Cardiomyopathy; MRI, T1 mapping; T2 mapping; Extracellular matrix; Native T1; Myocardium; Heart

MeSH Terms

Cardiomyopathies/*diagnostic imaging
Heart/diagnostic imaging
Humans
Image Interpretation, Computer-Assisted/methods
Magnetic Resonance Imaging/*methods
Prognosis

Figure

• 

  Fig. 1 Representative short-axis images of native T1, post-contrast T1 and T2, and extracellular volume fraction (ECV) maps of control subject. Pixels in generated map represent corresponding T1, T2, and ECV values of regions of interest in myocardium or other cardiac structures. Myocardium and other cardiovascular structures each have tissue-specific T1, T2, and ECV values.

• 

  Fig. 2 Apparent T1* and true T1 recovery. Comparison of longitudinal magnetization using standard inversion recovery and Look–Locker (LL) T1 mapping methods. With LL method, T1 recovery to steady state is achieved more rapidly and often denoted as apparent T1 (T1*). IR = inversion recovery, RF = radiofrequency

• 

  Fig. 3 Modified Look–Locker inversion recovery (MOLLI) with 5(3)3 protocol. MOLLI method features several modifications intended to improve accuracy and precision. This protocol employs two inversions and acquires three or five images after first and second inversions, with three RR intervals for T1 recovery. Images are sorted according to inversion time to perform pixel-wise three-parameter fitting. ECG = electrocardiogram, RR = the time interval between two consecutive R waves in the electrocardiogram, SSFP = steady-state free precession

• 

  Fig. 4 Shortened modified Look–Locker inversion recovery (ShMOLLI). ShMOLLI method employs conditional analysis algorithm that can distinguish between short and long T1 values using curve-fitting errors and, therefore, features shorter scan time than original MOLLI. Long T1 samples use set of samples from first inversion to estimate T1, whereas short T1 samples use set of samples from all inversions. ECG = electrocardiogram, SSFP = steady-state free precession, TI = Inversion time

• 

  Fig. 5 Saturation recovery single shot (SASHA). SASHA method acquires data at successive heartbeats by saturation recovery over RR-interval at different saturation times, using initial unperturbed image. Accuracy and precision depend on choice of two- or three-parameter fitting model. ECG = electrocardiogram, RR = the time inverval between two consecutive R waves in the electrocardiogram

• 

  Fig. 6 T2 mapping scheme with T2 preparation modules. T2-weighted images are acquired with different T2 preparation times, with same trigger delay time (TD), to ensure same cardiac cycle phase during breath-hold. T1 recovery time is needed to allow complete T1 recovery. This preparation module employs 90° and 180° pulses to create T2 decay via spin-spin relaxation during T2 preparation time. Module concludes with spoiler gradient for removal of residual transverse magnetization. ECG = electrocardiogram, GRE = gradient echo, SSFP = steady-state free precession

• 

  Fig. 7 T1 mapping in dilated cardiomyopathy (DCM). DCM is characterized by ventricular dilation and systolic dysfunction without other loading conditions. Approximately 30% of patients with DCM exhibit mid-wall late gadolinium enhancement (LGE) in regions that do not correspond to coronary artery territories. This imaging characteristic is known to be prognostic factor for DCM. However, many patients do not exhibit LGE—they usually present with increased native T1 and extracellular volume fraction values in areas without LGE. T1 mapping can detect diffuse myocardial abnormalities in areas that appear normal on LGE sequences.

• 

  Fig. 8 T1 mapping in hypertrophic cardiomyopathy (HCMP). HCMP is cardiac muscle disease characterized by abnormal left ventricle hypertrophy (LVH) in absence of another cause of LVH. Multifocal late gadolinium enhancement (LGE) is usually observed in hypertrophied muscles. T1 mapping can detect myocardial abnormalities in areas that do not exhibit LGE.

• 

  Fig. 9 T1 mapping in Fabry disease (FD). Left ventricle hypertrophy and late gadolinium enhancement (LGE) of inferolateral left ventricle wall are characteristic features of FD. However, only 50% of patients with FD exhibit LGE. In T1 mapping, decrease in septal native T1 value is characteristic feature that distinguishes FD from other cardiomyopathies.

• 

  Fig. 10 T1 and T2 mapping in amyloidosis. Global, circumferential, subendocardial late gadolinium enhancement (LGE) with distribution in non-coronary arterial territory is hallmark of amyloidosis. However, characteristic LGE patterns do not always occur. In patients with amyloidosis, marked elevations in native T1 and extracellular volume fraction values are characteristic imaging features, which do not overlap with those of other diseases. However, T2 values are not increased in patients with amyloidosis.

• 

  Fig. 11 T1 and T2 mapping in myocarditis. Late gadolinium enhancement (LGE) pattern in myocarditis is usually observed on lateral inferior wall of left ventricle, with subepicardial and mid-wall distribution. Non-contrast mapping parameters and T1 and T2 values are useful for diagnosis of myocarditis.

Reference

1. Yoon YE, Hong YJ, Kim HK, Kim JA, Na JO, Yang DH, et al. 2014 Korean guidelines for appropriate utilization of cardiovascular magnetic resonance imaging: a joint report of the Korean Society of Cardiology and the Korean Society of Radiology. Korean J Radiol. 2014; 15:659–688.

2. Piechnik SK, Ferreira VM, Lewandowski AJ, Ntusi NA, Banerjee R, Holloway C, et al. Normal variation of magnetic resonance T1 relaxation times in the human population at 1.5 T using ShMOLLI. J Cardiovasc Magn Reson. 2013; 15:13.

3. Mewton N, Liu CY, Croisille P, Bluemke D, Lima JA. Assessment of myocardial fibrosis with cardiovascular magnetic resonance. J Am Coll Cardiol. 2011; 57:891–903.

4. Radunski UK, Lund GK, Stehning C, Schnackenburg B, Bohnen S, Adam G, et al. CMR in patients with severe myocarditis: diagnostic value of quantitative tissue markers including extracellular volume imaging. JACC Cardiovasc Imaging. 2014; 7:667–675.

5. Moon JC, Messroghli DR, Kellman P, Piechnik SK, Robson MD, Ugander M, et al. Myocardial T1 mapping and extracellular volume quantification: a Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology consensus statement. J Cardiovasc Magn Reson. 2013; 15:92.

6. Piechnik SK, Ferreira VM, Dall'Armellina E, Cochlin LE, Greiser A, Neubauer S, et al. Shortened Modified Look-Locker Inversion recovery (ShMOLLI) for clinical myocardial T1-mapping at 1.5 and 3 T within a 9 heartbeat breathhold. J Cardiovasc Magn Reson. 2010; 12:69.

7. Chow K, Flewitt JA, Green JD, Pagano JJ, Friedrich MG, Thompson RB. Saturation recovery single-shot acquisition (SASHA) for myocardial T(1) mapping. Magn Reson Med. 2014; 71:2082–2095.

8. Messroghli DR, Greiser A, Fröhlich M, Dietz R, Schulz-Menger J. Optimization and validation of a fully-integrated pulse sequence for modified Look-Locker inversion-recovery (MOLLI) T1 mapping of the heart. J Magn Reson Imaging. 2007; 26:1081–1086.

9. Maestrini V, Treibel TA, White SK, Fontana M, Moon JC. T1 mapping for characterization of intracellular and extracellular myocardial diseases in heart failure. Curr Cardiovasc Imaging Rep. 2014; 7:9287.

10. Kellman P, Hansen MS. T1-mapping in the heart: accuracy and precision. J Cardiovasc Magn Reson. 2014; 16:2.

11. Dabir D, Child N, Kalra A, Rogers T, Gebker R, Jabbour A, et al. Reference values for healthy human myocardium using a T1 mapping methodology: results from the International T1 multicenter cardiovascular magnetic resonance study. J Cardiovasc Magn Reson. 2014; 16:69.

12. Karamitsos TD, Piechnik SK, Banypersad SM, Fontana M, Ntusi NB, Ferreira VM, et al. Noncontrast T1 mapping for the diagnosis of cardiac amyloidosis. JACC Cardiovasc Imaging. 2013; 6:488–497.

13. Bull S, White SK, Piechnik SK, Flett AS, Ferreira VM, Loudon M, et al. Human non-contrast T1 values and correlation with histology in diffuse fibrosis. Heart. 2013; 99:932–937.

14. Dass S, Suttie JJ, Piechnik SK, Ferreira VM, Holloway CJ, Banerjee R, et al. Myocardial tissue characterization using magnetic resonance noncontrast t1 mapping in hypertrophic and dilated cardiomyopathy. Circ Cardiovasc Imaging. 2012; 5:726–733.

15. Ugander M, Bagi PS, Oki AJ, Chen B, Hsu LY, Aletras AH, et al. Myocardial edema as detected by pre-contrast T1 and T2 CMR delineates area at risk associated with acute myocardial infarction. JACC Cardiovasc Imaging. 2012; 5:596–603.

16. Messroghli DR, Walters K, Plein S, Sparrow P, Friedrich MG, Ridgway JP, et al. Myocardial T1 mapping: application to patients with acute and chronic myocardial infarction. Magn Reson Med. 2007; 58:34–40.

17. Ferreira VM, Piechnik SK, Dall'Armellina E, Karamitsos TD, Francis JM, Choudhury RP, et al. Non-contrast T1-mapping detects acute myocardial edema with high diagnostic accuracy: a comparison to T2-weighted cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2012; 14:42.

18. Hinojar R, Foote L, Arroyo Ucar E, Jackson T, Jabbour A, Yu CY, et al. Native T1 in discrimination of acute and convalescent stages in patients with clinical diagnosis of myocarditis: a proposed diagnostic algorithm using CMR. JACC Cardiovasc Imaging. 2015; 8:37–46.

19. Sado DM, White SK, Piechnik SK, Banypersad SM, Treibel T, Captur G, et al. Identification and assessment of Anderson-Fabry disease by cardiovascular magnetic resonance noncontrast myocardial T1 mapping. Circ Cardiovasc Imaging. 2013; 6:392–398.

20. Sado DM, Maestrini V, Piechnik SK, Banypersad SM, White SK, Flett AS, et al. Noncontrast myocardial T1 mapping using cardiovascular magnetic resonance for iron overload. J Magn Reson Imaging. 2015; 41:1505–1511.

21. Pedersen SF, Thrysøe SA, Robich MP, Paaske WP, Ringgaard S, Bøtker HE, et al. Assessment of intramyocardial hemorrhage by T1-weighted cardiovascular magnetic resonance in reperfused acute myocardial infarction. J Cardiovasc Magn Reson. 2012; 14:59.

22. Verhaert D, Thavendiranathan P, Giri S, Mihai G, Rajagopalan S, Simonetti OP, et al. Direct T2 quantification of myocardial edema in acute ischemic injury. JACC Cardiovasc Imaging. 2011; 4:269–278.

23. Thavendiranathan P, Walls M, Giri S, Verhaert D, Rajagopalan S, Moore S, et al. Improved detection of myocardial involvement in acute inflammatory cardiomyopathies using T2 mapping. Circ Cardiovasc Imaging. 2012; 5:102–110.

24. Roller FC, Harth S, Schneider C, Krombach GA. T1, T2 Mapping and Extracellular Volume Fraction (ECV): application, value and further perspectives in myocardial inflammation and cardiomyopathies. Rofo. 2015; 187:760–770.

25. Crouser ED, Ono C, Tran T, He X, Raman SV. Improved detection of cardiac sarcoidosis using magnetic resonance with myocardial T2 mapping. Am J Respir Crit Care Med. 2014; 189:109–112.

26. Usman AA, Taimen K, Wasielewski M, McDonald J, Shah S, Giri S, et al. Cardiac magnetic resonance T2 mapping in the monitoring and follow-up of acute cardiac transplant rejection: a pilot study. Circ Cardiovasc Imaging. 2012; 5:782–790.

27. Giri S, Shah S, Xue H, Chung YC, Pennell ML, Guehring J, et al. Myocardial T2 mapping with respiratory navigator and automatic nonrigid motion correction. Magn Reson Med. 2012; 68:1570–1578.

28. von Knobelsdorff-Brenkenhoff F, Prothmann M, Dieringer MA, Wassmuth R, Greiser A, Schwenke C, et al. Myocardial T1 and T2 mapping at 3 T: reference values, influencing factors and implications. J Cardiovasc Magn Reson. 2013; 15:53.

29. Moon JC, Treibel TA, Schelbert EB. T1 mapping for diffuse myocardial fibrosis: a key biomarker in cardiac disease? J Am Coll Cardiol. 2013; 62:1288–1289.

30. Barison A, Grigoratos C, Todiere G, Aquaro GD. Myocardial interstitial remodelling in non-ischaemic dilated cardiomyopathy: insights from cardiovascular magnetic resonance. Heart Fail Rev. 2015; 20:731–749.

31. Perea RJ, Ortiz-Perez JT, Sole M, Cibeira MT, de Caralt TM, Prat-Gonzalez S, et al. T1 mapping: characterisation of myocardial interstitial space. Insights Imaging. 2015; 6:189–202.

32. de Jong S, van Veen TA, de Bakker JM, Vos MA, van Rijen HV. Biomarkers of myocardial fibrosis. J Cardiovasc Pharmacol. 2011; 57:522–535.

33. Miller CA, Naish JH, Bishop P, Coutts G, Clark D, Zhao S, et al. Comprehensive validation of cardiovascular magnetic resonance techniques for the assessment of myocardial extracellular volume. Circ Cardiovasc Imaging. 2013; 6:373–383.

34. Schelbert EB, Testa SM, Meier CG, Ceyrolles WJ, Levenson JE, Blair AJ, et al. Myocardial extravascular extracellular volume fraction measurement by gadolinium cardiovascular magnetic resonance in humans: slow infusion versus bolus. J Cardiovasc Magn Reson. 2011; 13:16.

35. Flett AS, Hayward MP, Ashworth MT, Hansen MS, Taylor AM, Elliott PM, et al. Equilibrium contrast cardiovascular magnetic resonance for the measurement of diffuse myocardial fibrosis: preliminary validation in humans. Circulation. 2010; 122:138–144.

36. Flett AS, Sado DM, Quarta G, Mirabel M, Pellerin D, Herrey AS, et al. Diffuse myocardial fibrosis in severe aortic stenosis: an equilibrium contrast cardiovascular magnetic resonance study. Eur Heart J Cardiovasc Imaging. 2012; 13:819–826.

37. Barison A, Del Torto A, Chiappino S, Aquaro GD, Todiere G, Vergaro G, et al. Prognostic significance of myocardial extracellular volume fraction in nonischaemic dilated cardiomyopathy. J Cardiovasc Med (Hagerstown). 2015; 16:681–687.

38. White SK, Sado DM, Flett AS, Moon JC. Characterising the myocardial interstitial space: the clinical relevance of non-invasive imaging. Heart. 2012; 98:773–779.

39. Ugander M, Oki AJ, Hsu LY, Kellman P, Greiser A, Aletras AH, et al. Extracellular volume imaging by magnetic resonance imaging provides insights into overt and sub-clinical myocardial pathology. Eur Heart J. 2012; 33:1268–1278.

40. Kellman P, Arai AE, Xue H. T1 and extracellular volume mapping in the heart: estimation of error maps and the influence of noise on precision. J Cardiovasc Magn Reson. 2013; 15:56.

41. White SK, Sado DM, Fontana M, Banypersad SM, Maestrini V, Flett AS, et al. T1 mapping for myocardial extracellular volume measurement by CMR: bolus only versus primed infusion technique. JACC Cardiovasc Imaging. 2013; 6:955–962.

42. Liu CY, Liu YC, Wu C, Armstrong A, Volpe GJ, van der Geest RJ, et al. Evaluation of age-related interstitial myocardial fibrosis with cardiac magnetic resonance contrast-enhanced T1 mapping: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol. 2013; 62:1280–1287.

43. Mongeon FP, Jerosch-Herold M, Coelho-Filho OR, Blankstein R, Falk RH, Kwong RY. Quantification of extracellular matrix expansion by CMR in infiltrative heart disease. JACC Cardiovasc Imaging. 2012; 5:897–907.

44. Messroghli DR, Plein S, Higgins DM, Walters K, Jones TR, Ridgway JP, et al. Human myocardium: single-breath-hold MR T1 mapping with high spatial resolution--reproducibility study. Radiology. 2006; 238:1004–1012.

45. Pykett IL, Rosen BR, Buonanno FS, Brady TJ. Measurement of spin-lattice relaxation times in nuclear magnetic resonance imaging. Phys Med Biol. 1983; 28:723–729.

46. Zhang Y, Yeung HN, O'Donnell M, Carson PL. Determination of sample time for T1 measurement. J Magn Reson Imaging. 1998; 8:675–681.

47. Look DC, Locker DR. Time saving in measurement of NMR and EPR relaxation times. Rev Sci Instrum. 1970; 41:250–251.

48. Messroghli DR, Radjenovic A, Kozerke S, Higgins DM, Sivananthan MU, Ridgway JP. Modified Look-Locker inversion recovery (MOLLI) for high-resolution T1 mapping of the heart. Magn Reson Med. 2004; 52:141–146.

49. Weingärtner S, Akçakaya M, Basha T, Kissinger KV, Goddu B, Berg S, et al. Combined saturation/inversion recovery sequences for improved evaluation of scar and diffuse fibrosis in patients with arrhythmia or heart rate variability. Magn Reson Med. 2014; 71:1024–1034.

50. Deichmann R, Haase A. Quantification of T1 values by SNAPSHOT-FLASH NMR imaging. J Magn Reson (1969). 1992; 96:608–612.

51. Hamlin SA, Henry TS, Little BP, Lerakis S, Stillman AE. Mapping the future of cardiac MR imaging: case-based review of T1 and T2 mapping techniques. Radiographics. 2014; 34:1594–1611.

52. Nacif MS, Turkbey EB, Gai N, Nazarian S, van der Geest RJ, Noureldin RA, et al. Myocardial T1 mapping with MRI: comparison of Look-Locker and MOLLI sequences. J Magn Reson Imaging. 2011; 34:1367–1373.

53. Gai N, Turkbey EB, Nazarian S, van der Geest RJ, Liu CY, Lima JA, et al. T1 mapping of the gadolinium-enhanced myocardium: adjustment for factors affecting interpatient comparison. Magn Reson Med. 2011; 65:1407–1415.

54. Kellman P, Wilson JR, Xue H, Ugander M, Arai AE. Extracellular volume fraction mapping in the myocardium, part 1: evaluation of an automated method. J Cardiovasc Magn Reson. 2012; 14:63.

55. Kellman P, Xue H, Chow K, Spottiswoode BS, Arai AE, Thompson RB. Optimized saturation recovery protocols for T1-mapping in the heart: influence of sampling strategies on precision. J Cardiovasc Magn Reson. 2014; 16:55.

56. Chow K, Spottiswoode BS, Pagano JJ, Thompson RB. Improved precision in SASHA T1 mapping with a variable flip angle readout. J Cardiovasc Magn Reson. 2014; 16:Suppl 1. M9.

57. Chow K, Kellman P, Spottiswoode BS, Nielles-Vallespin S, Arai AE, Salerno M, et al. Saturation pulse design for quantitative myocardial T1 mapping. J Cardiovasc Magn Reson. 2015; 17:84.

58. Roujol S, Weingärtner S, Foppa M, Chow K, Kawaji K, Ngo LH, et al. Accuracy, precision, and reproducibility of four T1 mapping sequences: a head-to-head comparison of MOLLI, ShMOLLI, SASHA, and SAPPHIRE. Radiology. 2014; 272:683–689.

59. Giri S, Chung YC, Merchant A, Mihai G, Rajagopalan S, Raman SV, et al. T2 quantification for improved detection of myocardial edema. J Cardiovasc Magn Reson. 2009; 11:56.

60. Abdel-Aty H, Simonetti O, Friedrich MG. T2-weighted cardiovascular magnetic resonance imaging. J Magn Reson Imaging. 2007; 26:452–459.

61. Foltz WD, Al-Kwifi O, Sussman MS, Stainsby JA, Wright GA. Optimized spiral imaging for measurement of myocardial T2 relaxation. Magn Reson Med. 2003; 49:1089–1097.

62. Iles L, Pfluger H, Phrommintikul A, Cherayath J, Aksit P, Gupta SN, et al. Evaluation of diffuse myocardial fibrosis in heart failure with cardiac magnetic resonance contrast-enhanced T1 mapping. J Am Coll Cardiol. 2008; 52:1574–1580.

63. Maron BJ, Towbin JA, Thiene G, Antzelevitch C, Corrado D, Arnett D, et al. Contemporary definitions and classification of the cardiomyopathies: an American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation. 2006; 113:1807–1816.

64. Hong YJ, Park CH, Kim YJ, Hur J, Lee HJ, Hong SR, et al. Extracellular volume fraction in dilated cardiomyopathy patients without obvious late gadolinium enhancement: comparison with healthy control subjects. Int J Cardiovasc Imaging. 2015; 31:Suppl 1. 115–122.

65. Sun Y, Weber KT. Cardiac remodelling by fibrous tissue: role of local factors and circulating hormones. Ann Med. 1998; 30:Suppl 1. 3–8.

66. McCrohon JA, Moon JC, Prasad SK, McKenna WJ, Lorenz CH, Coats AJ, et al. Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium-enhanced cardiovascular magnetic resonance. Circulation. 2003; 108:54–59.

67. Assomull RG, Prasad SK, Lyne J, Smith G, Burman ED, Khan M, et al. Cardiovascular magnetic resonance, fibrosis, and prognosis in dilated cardiomyopathy. J Am Coll Cardiol. 2006; 48:1977–1985.

68. Wu KC, Weiss RG, Thiemann DR, Kitagawa K, Schmidt A, Dalal D, et al. Late gadolinium enhancement by cardiovascular magnetic resonance heralds an adverse prognosis in nonischemic cardiomyopathy. J Am Coll Cardiol. 2008; 51:2414–2421.

69. Gulati A, Jabbour A, Ismail TF, Guha K, Khwaja J, Raza S, et al. Association of fibrosis with mortality and sudden cardiac death in patients with nonischemic dilated cardiomyopathy. JAMA. 2013; 309:896–908.

70. Kim EK, Chattranukulchai P, Klem I. Cardiac magnetic resonance scar imaging for sudden cardiac death risk stratification in patients with non-ischemic cardiomyopathy. Korean J Radiol. 2015; 16:683–695.

71. Puntmann VO, Voigt T, Chen Z, Mayr M, Karim R, Rhode K, et al. Native T1 mapping in differentiation of normal myocardium from diffuse disease in hypertrophic and dilated cardiomyopathy. JACC Cardiovasc Imaging. 2013; 6:475–484.

72. Yoon JH, Son JW, Chung H, Park CH, Kim YJ, Chang HJ, et al. Relationship between myocardial extracellular space expansion estimated with post-contrast T1 mapping MRI and left ventricular remodeling and neurohormonal activation in patients with dilated cardiomyopathy. Korean J Radiol. 2015; 16:1153–1162.

73. Mordi I, Carrick D, Bezerra H, Tzemos N. T1 and T2 mapping for early diagnosis of dilated non-ischaemic cardiomyopathy in middle-aged patients and differentiation from normal physiological adaptation. Eur Heart J Cardiovasc Imaging. 2016; 17:797–803.

74. Nishii T, Kono AK, Shigeru M, Takamine S, Fujiwara S, Kyotani K, et al. Cardiovascular magnetic resonance T2 mapping can detect myocardial edema in idiopathic dilated cardiomyopathy. Int J Cardiovasc Imaging. 2014; 30:Suppl 1. 65–72.

75. Jeserich M, Föll D, Olschewski M, Kimmel S, Friedrich MG, Bode C, et al. Evidence of myocardial edema in patients with nonischemic dilated cardiomyopathy. Clin Cardiol. 2012; 35:371–376.

76. aus dem Siepen F, Buss SJ, Messroghli D, Andre F, Lossnitzer D, Seitz S, et al. T1 mapping in dilated cardiomyopathy with cardiac magnetic resonance: quantification of diffuse myocardial fibrosis and comparison with endomyocardial biopsy. Eur Heart J Cardiovasc Imaging. 2015; 16:210–216.

77. Sado DM, Flett AS, Banypersad SM, White SK, Maestrini V, Quarta G, et al. Cardiovascular magnetic resonance measurement of myocardial extracellular volume in health and disease. Heart. 2012; 98:1436–1441.

78. Kono AK, Croisille P, Nishii T, Nishiyama K, Kyotani K, Shigeru M, et al. Cardiovascular magnetic resonance tagging imaging correlates with myocardial dysfunction and T2 mapping in idiopathic dilated cardiomyopathy. Int J Cardiovasc Imaging. 2014; 30:Suppl 2. 145–152.

79. Wong TC, Piehler K, Meier CG, Testa SM, Klock AM, Aneizi AA, et al. Association between extracellular matrix expansion quantified by cardiovascular magnetic resonance and short-term mortality. Circulation. 2012; 126:1206–1216.

80. Wong TC, Piehler KM, Kang IA, Kadakkal A, Kellman P, Schwartzman DS, et al. Myocardial extracellular volume fraction quantified by cardiovascular magnetic resonance is increased in diabetes and associated with mortality and incident heart failure admission. Eur Heart J. 2014; 35:657–664.

81. Maron BJ. Hypertrophic cardiomyopathy: a systematic review. JAMA. 2002; 287:1308–1320.

82. Ho CY, López B, Coelho-Filho OR, Lakdawala NK, Cirino AL, Jarolim P, et al. Myocardial fibrosis as an early manifestation of hypertrophic cardiomyopathy. N Engl J Med. 2010; 363:552–563.

83. Małek ŁA, Werys K, Kłopotowski M, Śpiewak M, Miłosz-Wieczorek B, Mazurkiewicz Ł, et al. Native T1-mapping for non-contrast assessment of myocardial fibrosis in patients with hypertrophic cardiomyopathy--comparison with late enhancement quantification. Magn Reson Imaging. 2015; 33:718–724.

84. Ellims AH, Iles LM, Ling LH, Hare JL, Kaye DM, Taylor AJ, et al. Diffuse myocardial fibrosis in hypertrophic cardiomyopathy can be identified by cardiovascular magnetic resonance, and is associated with left ventricular diastolic dysfunction. J Cardiovasc Magn Reson. 2012; 14:76.

85. Ho CY, Abbasi SA, Neilan TG, Shah RV, Chen Y, Heydari B, et al. T1 measurements identify extracellular volume expansion in hypertrophic cardiomyopathy sarcomere mutation carriers with and without left ventricular hypertrophy. Circ Cardiovasc Imaging. 2013; 6:415–422.

86. O'Mahony C, Elliott P. Anderson-Fabry disease and the heart. Prog Cardiovasc Dis. 2010; 52:326–335.

87. Moon JC, Sachdev B, Elkington AG, McKenna WJ, Mehta A, Pennell DJ, et al. Gadolinium enhanced cardiovascular magnetic resonance in Anderson-Fabry disease. Evidence for a disease specific abnormality of the myocardial interstitium. Eur Heart J. 2003; 24:2151–2155.

88. Pica S, Sado DM, Maestrini V, Fontana M, White SK, Treibel T, et al. Reproducibility of native myocardial T1 mapping in the assessment of Fabry disease and its role in early detection of cardiac involvement by cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2014; 16:99.

89. Thompson RB, Chow K, Khan A, Chan A, Shanks M, Paterson I, et al. T₁ mapping with cardiovascular MRI is highly sensitive for Fabry disease independent of hypertrophy and sex. Circ Cardiovasc Imaging. 2013; 6:637–645.

90. Falk RH, Comenzo RL, Skinner M. The systemic amyloidoses. N Engl J Med. 1997; 337:898–909.

91. Ruberg FL. T1 mapping in cardiac amyloidosis: can we get there from here? JACC Cardiovasc Imaging. 2013; 6:498–500.

92. Kyle RA, Greipp PR, O'Fallon WM. Primary systemic amyloidosis: multivariate analysis for prognostic factors in 168 cases. Blood. 1986; 68:220–224.

93. Banypersad SM, Sado DM, Flett AS, Gibbs SD, Pinney JH, Maestrini V, et al. Quantification of myocardial extracellular volume fraction in systemic AL amyloidosis: an equilibrium contrast cardiovascular magnetic resonance study. Circ Cardiovasc Imaging. 2013; 6:34–39.

94. Falk RH, Skinner M. The systemic amyloidoses: an overview. Adv Intern Med. 2000; 45:107–137.

95. Maceira AM, Prasad SK, Hawkins PN, Roughton M, Pennell DJ. Cardiovascular magnetic resonance and prognosis in cardiac amyloidosis. J Cardiovasc Magn Reson. 2008; 10:54.

96. Brooks J, Kramer CM, Salerno M. Markedly increased volume of distribution of gadolinium in cardiac amyloidosis demonstrated by T1 mapping. J Magn Reson Imaging. 2013; 38:1591–1595.

97. Austin BA, Tang WH, Rodriguez ER, Tan C, Flamm SD, Taylor DO, et al. Delayed hyper-enhancement magnetic resonance imaging provides incremental diagnostic and prognostic utility in suspected cardiac amyloidosis. JACC Cardiovasc Imaging. 2009; 2:1369–1377.

98. Fontana M, Chung R, Hawkins PN, Moon JC. Cardiovascular magnetic resonance for amyloidosis. Heart Fail Rev. 2015; 20:133–144.

99. Banypersad SM, Fontana M, Maestrini V, Sado DM, Captur G, Petrie A, et al. T1 mapping and survival in systemic light-chain amyloidosis. Eur Heart J. 2015; 36:244–251.

100. Fontana M, Banypersad SM, Treibel TA, Maestrini V, Sado DM, White SK, et al. Native T1 mapping in transthyretin amyloidosis. JACC Cardiovasc Imaging. 2014; 7:157–165.

101. Sparrow P, Amirabadi A, Sussman MS, Paul N, Merchant N. Quantitative assessment of myocardial T2 relaxation times in cardiac amyloidosis. J Magn Reson Imaging. 2009; 30:942–946.

102. Luetkens JA, Doerner J, Thomas DK, Dabir D, Gieseke J, Sprinkart AM, et al. Acute myocarditis: multiparametric cardiac MR imaging. Radiology. 2014; 273:383–392.

103. Iles LM, Taylor AJ. Is one better than two?: T1 mapping in myocarditis. JACC Cardiovasc Imaging. 2013; 6:1059–1061.

104. Ferreira VM, Piechnik SK, Dall'Armellina E, Karamitsos TD, Francis JM, Ntusi N, et al. T(1) mapping for the diagnosis of acute myocarditis using CMR: comparison to T2-weighted and late gadolinium enhanced imaging. JACC Cardiovasc Imaging. 2013; 6:1048–1058.

105. Ferreira VM, Piechnik SK, Dall'Armellina E, Karamitsos TD, Francis JM, Ntusi N, et al. Native T1-mapping detects the location, extent and patterns of acute myocarditis without the need for gadolinium contrast agents. J Cardiovasc Magn Reson. 2014; 16:36.

106. Luetkens JA, Homsi R, Sprinkart AM, Doerner J, Dabir D, Kuetting DL, et al. Incremental value of quantitative CMR including parametric mapping for the diagnosis of acute myocarditis. Eur Heart J Cardiovasc Imaging. 2016; 17:154–161.

107. Bohnen S, Radunski UK, Lund GK, Kandolf R, Stehning C, Schnackenburg B, et al. Performance of T1 and T2 mapping cardiovascular magnetic resonance to detect active myocarditis in patients with recent-onset heart failure. Circ Cardiovasc Imaging. 2015; 8:e003073.

108. Rajiah P, Desai MY, Kwon D, Flamm SD. MR imaging of myocardial infarction. Radiographics. 2013; 33:1383–1412.

109. Arai AE. Magnetic resonance imaging for area at risk, myocardial infarction, and myocardial salvage. J Cardiovasc Pharmacol Ther. 2011; 16:313–320.

110. Friedrich MG, Kim HW, Kim RJ. T2-weighted imaging to assess post-infarct myocardium at risk. JACC Cardiovasc Imaging. 2011; 4:1014–1021.

111. Bulluck H, White SK, Rosmini S, Bhuva A, Treibel TA, Fontana M, et al. T1 mapping and T2 mapping at 3T for quantifying the area-at-risk in reperfused STEMI patients. J Cardiovasc Magn Reson. 2015; 17:73.

112. Dall'Armellina E, Piechnik SK, Ferreira VM, Si QL, Robson MD, Francis JM, et al. Cardiovascular magnetic resonance by non contrast T1-mapping allows assessment of severity of injury in acute myocardial infarction. J Cardiovasc Magn Reson. 2012; 14:15.

113. Choi EY, Hwang SH, Yoon YW, Park CH, Paek MY, Greiser A, et al. Correction with blood T1 is essential when measuring post-contrast myocardial T1 value in patients with acute myocardial infarction. J Cardiovasc Magn Reson. 2013; 15:11.

114. Chan W, Duffy SJ, White DA, Gao XM, Du XJ, Ellims AH, et al. Acute left ventricular remodeling following myocardial infarction: coupling of regional healing with remote extracellular matrix expansion. JACC Cardiovasc Imaging. 2012; 5:884–893.

115. Ferreira VM, Holloway CJ, Piechnik SK, Karamitsos TD, Neubauer S. Is it really fat? Ask a T1-map. Eur Heart J Cardiovasc Imaging. 2013; 14:1060.

116. Kali A, Choi EY, Sharif B, Kim YJ, Bi X, Spottiswoode B, et al. Native T1 Mapping by 3-T CMR Imaging for Characterization of Chronic Myocardial Infarctions. JACC Cardiovasc Imaging. 2015; 8:1019–1030.

117. Bauner KU, Biffar A, Theisen D, Greiser A, Zech CJ, Nguyen ET, et al. Extracellular volume fractions in chronic myocardial infarction. Invest Radiol. 2012; 47:538–545.

118. Puntmann VO, D'Cruz D, Smith Z, Pastor A, Choong P, Voigt T, et al. Native myocardial T1 mapping by cardiovascular magnetic resonance imaging in subclinical cardiomyopathy in patients with systemic lupus erythematosus. Circ Cardiovasc Imaging. 2013; 6:295–301.

119. Ntusi NA, Piechnik SK, Francis JM, Ferreira VM, Rai AB, Matthews PM, et al. Subclinical myocardial inflammation and diffuse fibrosis are common in systemic sclerosis--a clinical study using myocardial T1-mapping and extracellular volume quantification. J Cardiovasc Magn Reson. 2014; 16:21.

120. Ntusi NA, Piechnik SK, Francis JM, Ferreira VM, Matthews PM, Robson MD, et al. Diffuse myocardial fibrosis and inflammation in rheumatoid arthritis: insights from CMR T1 mapping. JACC Cardiovasc Imaging. 2015; 8:526–536.

121. Mavrogeni S, Markousis-Mavrogenis G, Papavasiliou A, Kolovou G. Cardiac involvement in Duchenne and Becker muscular dystrophy. World J Cardiol. 2015; 7:410–414.

122. Reiter U, Reiter G, Dorr K, Greiser A, Maderthaner R, Fuchsjäger M. Normal diastolic and systolic myocardial T1 values at 1.5-T MR imaging: correlations and blood normalization. Radiology. 2014; 271:365–372.