Diffusion-weighted imaging in hypertrophic cardiomyopathy: association with high T2-weighted signal intensity in additio
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ORIGINAL PAPER
Diffusion‑weighted imaging in hypertrophic cardiomyopathy: association with high T2‑weighted signal intensity in addition to late gadolinium enhancement Ruo‑yang Shi1 · Dong‑aolei An1 · Bing‑hua Chen1 · Rui Wu1 · Liang Du2 · Meng Jiang3 · Jian‑rong Xu1 · Lian‑ming Wu1 Received: 8 May 2020 / Accepted: 3 July 2020 © Springer Nature B.V. 2020
Abstract Diffusion-weighted imaging (DWI) has been confirmed to be associated with late gadolinium enhancement (LGE) in hypertrophic cardiomyopathy (HCM). In this context, we aimed to study whether DWI could reflect the active tissue injury and edema information of HCM which were usually indicated by T2 weighted images. Forty HCM patients were examined using a 3.0 T magnetic resonance scanner. Cine, T2-weighted short tau inversion recovery (T2-STIR), DWI and LGE sequences were acquired. T1 mapping was also included to quantify the focal and diffuse fibrosis. Cardiac troponin I (cTnI) was tested to assess the recently myocardial injury. Student’s t-test, Mann–Whitney U test, One-way analysis, Kruskal–Wallis analysis, the Spearman correlation analysis, and multivariable regression were used in this study. The apparent diffusion coefficient (ADC) was significantly elevated in the cTnI positive group (P = 0.01) and correlated with LGE (ρ = 0.312, P = 0.049) and HighT2 extent (ρ = 0.443, P = 0.004) in the global level. In the segmental analysis, the ADC significantly differentiated the segments with and without HighT2/LGE presence (P = 0.00). The average ADC values were higher in segments with HighT2 and LGE coexistence than in those with only LGE presence (P 0.04 ng/ml) Cardiovascular risk Hypertension Dyslipidaemia Diabetes Current smoker Symptom Chest pain NYHA class (I ~ II/III ~ IV) CMR imaging EDV (ml) ESV (ml) LVEF (%) LVMi (ml/m2) LVOT Obstruction High T2-STIR extent (% of LVM) High T2-STIR extent (segments) LGE extent (% of LVM) LGE extent (segments) T1 value (ms) ECV (%) ADC (10–6 mm2/s)
52.60 ± 16.92 14/26 1.82 ± 0.23 67.28 ± 9.08 12 (30%) 7 (17.5%) 10 (25%) 3 (7.5%) 4 (10%) 14 (35%) 29/11 122.62 ± 27.88 33.53 ± 13.73 73.18 ± 6.97 99.53 ± 31.95 14 10.35 ± 8.84 3.18 ± 2.74 15.33 ± 13.77 5.05 ± 3.99 1315.08 ± 66.19 31.52 ± 5.01 1987.69 ± 222.78
NYHA New York Heart Association; EDV end diastolic volume; ESV end systolic volume; LVEF left ventricular ejection fraction; LVMi left ventricular mass index; LVOT left ventricular outflow tract; HighT2 high signal intensity on T2 weighted imaging; LGE late gadolinium enhancement; ECV extracellular volume fraction; ADC apparent diffusion coefficient
Study population Forty-six consecutive patients with HCM were enrolled between August 2017 and March 2018. The patients were diagnosed as HCM by echocardiography or cardiac magnetic resonance imaging (CMR) and confirmed not having another disease that could cause hypertrophy. Patients with a history of hypertension were carefully reviewed about his/her medical history and CMR images (n = 7). All patients had a haematocrit, serum myocardial enzyme tes
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