High Spatial Resolution Cardiovascular Magnetic Resonance at 7.0 Tesla in Patients with Hypertrophic Cardiomyopathy - First Experiences: Lesson Learned from 7.0 Tesla

PLoS One. 2016 Feb 10;11(2):e0148066. doi: 10.1371/journal.pone.0148066. eCollection 2016.

Abstract

Background: Cardiovascular Magnetic Resonance (CMR) provides valuable information in patients with hypertrophic cardiomyopathy (HCM) based on myocardial tissue differentiation and the detection of small morphological details. CMR at 7.0T improves spatial resolution versus today's clinical protocols. This capability is as yet untapped in HCM patients. We aimed to examine the feasibility of CMR at 7.0T in HCM patients and to demonstrate its capability for the visualization of subtle morphological details.

Methods: We screened 131 patients with HCM. 13 patients (9 males, 56 ±31 years) and 13 healthy age- and gender-matched subjects (9 males, 55 ±31years) underwent CMR at 7.0T and 3.0T (Siemens, Erlangen, Germany). For the assessment of cardiac function and morphology, 2D CINE imaging was performed (voxel size at 7.0T: (1.4x1.4x2.5) mm3 and (1.4x1.4x4.0) mm3; at 3.0T: (1.8x1.8x6.0) mm3). Late gadolinium enhancement (LGE) was performed at 3.0T for detection of fibrosis.

Results: All scans were successful and evaluable. At 3.0T, quantification of the left ventricle (LV) showed similar results in short axis view vs. the biplane approach (LVEDV, LVESV, LVMASS, LVEF) (p = 0.286; p = 0.534; p = 0.155; p = 0.131). The LV-parameters obtained at 7.0T where in accordance with the 3.0T data (pLVEDV = 0.110; pLVESV = 0.091; pLVMASS = 0.131; pLVEF = 0.182). LGE was detectable in 12/13 (92%) of the HCM patients. High spatial resolution CINE imaging at 7.0T revealed hyperintense regions, identifying myocardial crypts in 7/13 (54%) of the HCM patients. All crypts were located in the LGE-positive regions. The crypts were not detectable at 3.0T using a clinical protocol.

Conclusions: CMR at 7.0T is feasible in patients with HCM. High spatial resolution gradient echo 2D CINE imaging at 7.0T allowed the detection of subtle morphological details in regions of extended hypertrophy and LGE.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cardiomyopathy, Hypertrophic / pathology*
  • Case-Control Studies
  • Echocardiography
  • Female
  • Fibrosis / pathology
  • Gadolinium / chemistry
  • Healthy Volunteers
  • Heart Ventricles / pathology*
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Magnetic Resonance Imaging, Cine / methods*
  • Male
  • Middle Aged
  • Prospective Studies

Substances

  • Gadolinium

Grants and funding

The study was supported by university funds (Charité) hold by Prof. Dr. med. Jeanette Schulz Menger. Thoralf Niendorf is founder and CEO of MRI.TOOLS GmbH, Berlin, Germany. Jan Rieger is founder and CTO of MRI.TOOLS GmbH, Berlin, Germany. Darius Lysiak is currently employee of MRI.TOOLS GmbH, Berlin, Germany. MRI.TOOLS GmbH provided support in the form of salaries for authors Jan Rieger and Darius Lysiak, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.