Myocardial extracellular volume fraction measurements with MOLLI 5(3)3 by cardiovascular MRI for the discrimination of healthy volunteers from dilated and hypertrophic cardiomyopathy patients

Abstract

Aim: To investigate the diagnostic performance of myocardial native T1 time and the extracellular volume fraction (ECV) for differentiating dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) patients from healthy volunteers.

Materials and methods: Forty healthy volunteers, 57 DCM patients, and 30 HCM patients were enrolled, all of whom underwent cardiovascular magnetic resonance imaging (CMRI), including late gadolinium enhancement (LGE) and native and post-contrast T1 mapping acquired with the modified Look-Locker inversion recovery (MOLLI) sequence on a 1.5 T MRI system. ECV were calculated by native and post-contrast T1 times. Multivariate binary logistic regression analyses and receiver operating characteristic (ROC) curve analyses were used to assess the concordance with the clinical diagnosis of DCM and HCM.

Results: DCM and HCM patients had significantly higher myocardial native T1 times and ECVs than healthy volunteers (p<0.001). Multivariate logistic regression analyses showed that ECV was an independent predictor of DCM and HCM diagnosis (OR=1.556, p<0.001 and OR=1.847, p=0.001, respectively). ROC curve analysis indicated that ECV provided greater distinction between DCM patients and healthy volunteers than native T1 time (AUC: 0.889 versus 0.780, p=0.021). At the optimal cut-off value, ECV identified DCM and HCM patients with 80.7% and 83.3% sensitivity, 87.5% and 70% specificity, 90.2% and 67.6% positive predictive value, and 76.1% and 84.8% negative predictive value, respectively.

Conclusion: The increased ECV in DCM and HCM patients reflects myocardial extracellular matrix expansion. Myocardial ECV provides good diagnostic performance for identifying DCM and HCM patients from healthy volunteers.