Application Of 3.0T Magnetic Resonance T1 Mapping Technique In Differential Diagnosis Of Myocardial Amyloidosis And Hypertrophic Cardiomyopathy

Objective:Cardiac amyloidosis(CA)and hypertrophic cardiomyopathy(HCM)are two distinct disease entities that may share similar phenotypes including increased left ventricular(LV)wall thickness.Since the treatment and prognosis are quite different,differential diagnosis between AL and HCM is crucial.This study aimed to investigate the differential diagnostic value of cardiovascular magnetic resonance(CMR)T1 mapping parameters between AL and HCM.Material and Methods:This study was approved by the institutional review board.We retrospectively included 19 CA patients with positive endomyocardial biopsy,15 HCM patients who met the clinical diagnostic criteria and 20 healthy volunteers between January 2015 and December 2016.All subjects underwent 3.0 Tesla CMR with late gadolinium enhancement(LGE)imaging and T1 mapping using a Modified Look-Lockers Inversion-recovery(MOLLI)sequence.Native T1,Post T1 and ECV were measured semi-automatically using a dedicated CMR software.Receiver-operating characteristic(ROC)curve analysis was performed.Results:Compared with HCM patients,AL patients had significantly higher native T1(1457±164ms vs1330±45ms,P=0.000)and ECV(0.50±0.09 vs 0.29±0.07,P=0.000).A Native T1 cut-off value of 1366 ms yielded 84.2%sensitivity,85.7%specificity and 85.0%accuracy to diagnose CA.An ECV cut-off value of 0.43 yielded 85.0%sensitivity,92.3%specificity and 88.0%accuracy to diagnose CA.Conclusion:T1 mapping was a reliable tool to differentiate CA from HCM.