In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to EACVI Silver Members, Fellows of the ESC and Young combined Members

Inflammatory reactions of the pericardium as measured with parametric mapping CMR

Session Poster session 2

Speaker Mareike Cramer

Event : EuroCMR 2019

  • Topic : imaging
  • Sub-topic : Cardiac Magnetic Resonance: Pericardium
  • Session type : Poster Session

Authors : M Gastl (Zurich,CH), J Sokolska (Zurich,CH), M Polacin (Zurich,CH), H Alkadhi (Zurich,CH), S Kozerke (Zurich,CH), R Manka (Zurich,CH)

M Gastl1 , J Sokolska1 , M Polacin2 , H Alkadhi2 , S Kozerke3 , R Manka1 , 1University Heart Center - Zurich - Switzerland , 2University Hospital Zurich, Institute of Diagnostic and Interventional Radiology - Zurich - Switzerland , 3Swiss Federal Institute of Technology Zurich (ETH Zurich), Institute for Biomedical Engineering - Zurich - Switzerland ,

European Heart Journal - Cardiovascular Imaging ( 2019 ) 20 ( Supplement 2 ), ii372

Background: Despite the improved spectrum of diagnostic tools and technical developments, diagnosis of pericardial inflammation can remain challenging. Cardiovascular magnetic resonance (CMR) is increasingly used to diagnose pericardial inflammation through the visualization of thickened pericardium, pericardial edema and contrast agent uptake. Unlike T1- and T2-weighted imaging, parametric mapping (T1 and T2 mapping) has emerged as an alternative to visualize and quantify focal and global changes of the myocardium. 
Purpose:To investigate the role of parametric mapping for the diagnosis of pericardial inflammation.
Methods:Twelve patients with suspected or known pericardial inflammation underwent CMR at a 1.5T system including T1/T2 black blood imaging with fat suppression (SPIR), T1/T2 mapping and a 3D gradient-spoiled fast-field-echo sequence for late gadolinium enhancement (LGE).  T1/T2 mapping was performed in end-diastole covering 3 short axis slices (T1: TR shortest, TE shortest, 11 images; T2-GraSE: TR 1 heartbeat, TE shortest, 9 echoes). The diagnosis of pericardial inflammation was made according to recent guidelines using LGE imaging and T1/T2 black blood. T1 and T2 measurements were pursued by manually drawing a region of interest (ROI) in the pericardium of all slices avoiding contamination by other cardiac structures, e.g. epicardial fat. 
Results:T1 mapping could be performed in all subjects, T2 maps could only be analysed in 5 patients. In addition to pericardial inflammation, 3 patients displayed myocardial involvement.  On average, the pericardium displayed a thickness of 6.7±2.0 mm. T1 values were 1394.7±318.8 ms and T2 values were 149.4±24.6 ms, which was above local reference and patients' myocardial values (Myocardial T1: 1031.5±42.1 ms, p=0.003; T2: 50.2±1.2 ms, p=0.001). Both, T1 and T2, did not show a correlation to the extent of the thickened pericardium. There was no correlation of T1/T2 to blood markers of inflammation and myocardial injury (CRP, troponin, CK).
Conclusions: Parametric T1 and T2 mapping was able to support the diagnosis of pericardial inflammation by T1/T2-weighted and LGE imaging. Because of partial volume effects of the healthy, thin pericardium, the implementation of normal values can be hampered.

Members get more

Join now
  • 1ESC Professional Members – access all resources from general ESC events 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are