T2 Relaxation Times at Cardiac MRI in Healthy Adults: A Systematic Review and Meta-Analysis

Abstract

Background T2 mapping is an important cardiac MRI technique with applications in various conditions. However, a comprehensive evaluation of the T2 literature for normal values is lacking. Purpose To characterize the ranges of normal values and variability of myocardial T2 relaxation times using a systematic review and meta-analysis of the T2 literature. Materials and Methods PubMed and Cochrane Central were searched from June 2019 to January 2020 for myocardial T2 measurements in healthy adults. Studies quantifying T2 relaxation times conducted at 1.5 T or 3.0 T using gradient and spin-echo (GRASE) or T2-prepared balanced steady-state free precession sequences were included. Summary means were generated using a random-effects model. Subgroup analysis and meta-regression were performed to assess factors causing heterogeneity. Results Of the 2481 articles retrieved, 42 studies were included with 954 healthy adults (mean age, 42.4 years ± 10.5 [standard deviation]; 538 men). The pooled mean of T2 across studies was 52 msec at 1.5 T (95% confidence interval [CI]: 51 msec, 53 msec) and 46 msec at 3.0 T (95% CI: 44 msec, 48 msec) (P ≤ .001). I² was 98% at 1.5 T and 3.0 T. Meta-regression at 1.5 T and 3.0 T identified vendor (β at 1.5 T = -4 msec [with Philips as reference], P < .001; β at 3.0 T = -5 msec, P = .02) and pulse sequence (β at 1.5 T = -5 msec [with GRASE as reference], P < .001; β at 3.0 T = -6 msec, P = .002) as significant covariates, but it did not identify any association with covariates of age (β at 1.5 T = 0 msec per year, P = .70; β at 3.0 T = 0 msec per year, P = .83) or sex (β at 1.5 T = -1 msec, P = .88; β at 3.0 T = 6 msec, P = .42). Conclusion The pooled mean of T2 relaxation times in healthy adults had marked heterogeneity across studies with field strength, vendor, and pulse sequence identified as covariates associated with T2. T2-prepared measurements were similar between vendors at each field strength. © RSNA, 2020 Online supplemental material is available for this article.

Graphical abstract

Figure 1:

Preferred Items for Systematic Reviews and Meta-Analysis flowchart of study review process. GRASE = gradient and spin echo, T2P = T2 prepared.

Figure 2:

Forest plots of T2 studies show T2 relaxation times at cardiac MRI at 1.5 T in healthy adults. Studies are grouped by vendor and pulse sequences. A, T2 studies performed with a Siemens scanner at 1.5 T using T2-prepared (T2P) sequence. B, T2 studies performed with a Philips scanner at 1.5 T using gradient and spin-echo sequence (GRASE). C, T2 studies performed with a Philips scanner at 1.5 T using T2P sequence. Studies with multiple subgroups are noted by author’s last name, year of publication, and number of patients in each study. CI = confidence interval.

Figure 3:

Forest plots of T2 studies show T2 relaxation times at cardiac MRI at 3.0 T in healthy adults. Studies are grouped by vendor and pulse sequences. A, T2 studies performed with a Siemens scanner at 3.0 T using T2-prepared (T2P) sequence, B, T2 studies performed with a Philips scanner at 3.0 T using gradient and spin-echo sequence (GRASE), C, T2 studies performed with a Philips scanner at 3.0 T using T2P sequence. Studies with multiple subgroups are noted by author’s last name, year of publication, and number of patients in each study. CI = confidence interval, N/A = not applicable.