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Meta-Analysis
. 2016 Dec 12;18(1):92.
doi: 10.1186/s12968-016-0313-7.

Histologic validation of myocardial fibrosis measured by T1 mapping: a systematic review and meta-analysis

Kai-Yue Diao  1   2 , Zhi-Gang Yang  3 , Hua-Yan Xu  2 , Xi Liu  2 , Qin Zhang  2 , Ke Shi  2 , Li Jiang  2 , Lin-Jun Xie  1   2 , Ling-Yi Wen  1 , Ying-Kun Guo  4
Affiliations
Meta-Analysis

Histologic validation of myocardial fibrosis measured by T1 mapping: a systematic review and meta-analysis

Kai-Yue Diao et al. J Cardiovasc Magn Reson. .

Abstract

Background: Myocardial fibrosis is being increasingly recognised as a common final pathway of a wide range of diseases. Thus, the development of an accurate and convenient method to evaluate myocardial fibrosis is of major importance. Although T1 mapping is a potential alternative for myocardial biopsy, validation studies are limited to small numbers and vary regarding technical facets, and include only a restricted number of disease. A systematic review and meta-analysis was conducted to objectively and comprehensively evaluate the performance of T1 mapping on the quantification of myocardial fibrosis using cardiovascular magnetic resonance (CMR).

Methods: PubMed, EMBASE and the Cochrane Library databases were searched for studies applying T1 mapping to measure myocardial fibrosis and that validated the results via histological analysis. A pooled correlation coefficient between the CMR and histology measurements was used to evaluate the performance of the T1 mapping.

Results: A total of 15 studies, including 308 patients who had CMR and myocardial biopsy were included and the pooled correlation coefficient between ECV measured by T1 mapping and biopsy for the selected studies was 0.884 (95% CI: 0.854, 0.914) and was not notably heterogeneous chi-squared = 7.44; P = 0.489 for the Q test and I^2 = 0.00%).

Conclusions: The quantitative measurement of myocardial fibrosis via T1 mapping is associated with a favourable overall correlation with the myocardial biopsy measurements. Further studies are required to determine the calibration of the T1 mapping results for the biopsy findings of different cardiomyopathies.

Keywords: Cardiovascular magnetic resonance, T1 mapping; Myocardial fibrosis.

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Figures

Fig. 1
Fig. 1
The graph on the left shows recovery curves for a septal region of interest and the blood pool, generated from images at the corresponding time point (a) (b) (c) in the recovery curves, shown in the bottom row, taken at different times after an inversion pulse at time = 0. The T1 for each pixel location can be used to generate a T1 map, as shown in the top-right images, and performing this technique for all pixels in the image yields a colored T1 MOLLI map (bottom right)
Fig. 2
Fig. 2
Flow diagram of the study selection process
Fig. 3
Fig. 3
Study quality evaluated by QUADAS-2 tool. Grouped bar chart displays the cumulative score of the 15 included studies for each fields of the QUADAS questions. Green bar = “low” risk, yellow bar = “unclear” risk, and red bar = “high” risk. The questions are listed in Table 2
Fig. 4
Fig. 4
Forest plot of the correlation coefficients between ECV and histology CVF measurement
Fig. 5
Fig. 5
Forest plot of the correlation coefficients between post-contrast T1 time and histology CVF measurement
Fig. 6
Fig. 6
Forest plot of the correlation coefficients between native T1 time and histology CVF measurement
See this image and copyright information in PMC

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