Extracellular volume - myocardium
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Extracellular volume (ECV)
Extracellular volume (ECV) refers tothe space or volume of a tissue, which is not occupied by cells. Apart from the usual extracellular space, which surrounds the cells of a specific tissue it also includes the intracapillary plasma volume 1,2. It measures the space, which is occupied by the extracellular matrix 1-4.
Measurement
A series of native T1 and postcontrast T1 images an acquired and co-registered. This can be done by an equilibrium infusion or after a bolus injection after waiting for a sufficient amount of time (15min) 1-5. T1 values can then be calculated pixel-wise from a signal intensity versus time curve fitting model 2. The administration of gadolinium leads to shortening of the T1 value. Extracellular volume can be then calculated using the following formula 4:
ECV = (1-hct) [(1/pT1my - 1/nT1my) / (1/pT1bp - 1/nT1bp)]
nT1 = native T1, pT1m postcontrast T1, my = myocardium, bp = blood pool , hct = haematocrit
Interpretation
It is of interest in the myocardium as a biomarker for interstitial disease. In the absence of any diffuse infiltrative disease or myocardial oedema, it can be also considered as a biomarker for fibrosis 1-4.
Apart from fibrosis, it is elevated in the following myocardial diseases 1-4:
·
-
cardiac amyloidosis
o- ATTR-amyloidosis – prognostic value
o - AL-amyloidosis
·
- ATTR-amyloidosis – prognostic value
- myocarditis
· - acute myocardial infarction
· - scar tissue
Low values can occur in 4:
·
- lipomatous metaplasia/fat
· - cardiac thrombus
Influencing factors
Unlike native T1 extracellular volume (ECV)seems not to be dependant on field strength, but similar to native T1 it varies between systole and diastole 2,4. There are only minor differences in regard to the myocardial region 6.
See also
-<p><strong>Extracellular volume (ECV)</strong></p><p><strong>Extracellular volume (ECV) </strong>refers to<strong> </strong>the space or volume of a tissue, which is not occupied by cells. Apart from the usual extracellular space, which surrounds the cells of a specific tissue it also includes the intracapillary plasma volume <sup>1,2</sup>. It measures the space, which is occupied by the extracellular matrix <sup>1-4</sup>.</p><h4>Measurement</h4><p>A series of native T1 and postcontrast T1 images an acquired and co-registered. This can be done by an equilibrium infusion or after a bolus injection after waiting for a sufficient amount of time (15min) <sup>1-5</sup>. T1 values can then be calculated pixel-wise from a signal intensity versus time curve fitting model <sup>2</sup>. The administration of gadolinium leads to shortening of the T1 value. Extracellular volume can be then calculated using the following formula <sup>4</sup>:</p><p><!--[if gte msEquation 12]><m:oMathPara><m:oMathParaPr><m:jc- +<p><strong>Extracellular volume (ECV) </strong>refers to<strong> </strong>the space or volume of a tissue, which is not occupied by cells. Apart from the usual extracellular space, which surrounds the cells of a specific tissue it also includes the intracapillary plasma volume <sup>1,2</sup>. It measures the space, which is occupied by the extracellular matrix <sup>1-4</sup>.</p><h4>Measurement</h4><p>A series of native T1 and postcontrast T1 images an acquired and co-registered. This can be done by an equilibrium infusion or after a bolus injection after waiting for a sufficient amount of time (15min) <sup>1-5</sup>. T1 values can then be calculated pixel-wise from a signal intensity versus time curve fitting model <sup>2</sup>. The administration of gadolinium leads to shortening of the T1 value. Extracellular volume can be then calculated using the following formula <sup>4</sup>:</p><p>ECV = (1-hct) [(1/pT1<sub>my</sub> - 1/nT1<sub>my</sub>) / (1/pT1<sub>bp</sub> - 1/nT1<sub>bp</sub>)] </p><p><!--[if gte msEquation 12]><m:oMathPara><m:oMathParaPr><m:jc
-</v:shape><![endif]--><!--[if !vml]--><!--[endif]--><!--[endif]--></p><p>nT1 = native T1, pT1m postcontrast T1, my = myocardium, bp = blood pool , hct = haematocrit</p><h4>Interpretation</h4><p>It is of interest in the myocardium as a biomarker for interstitial disease. In the absence of any diffuse infiltrative disease or myocardial oedema it can be also considered as a biomarker for fibrosis <sup>1-4</sup>.</p><p>Apart from fibrosis, it is elevated in the following myocardial diseases <sup>1-4</sup>:</p><p><!--[if !supportLists]-->· <!--[endif]-->amyloidosis</p><p><!--[if !supportLists]-->o <!--[endif]-->ATTR-amyloidosis – prognostic value</p><p><!--[if !supportLists]-->o <!--[endif]-->AL-amyloidosis</p><p><!--[if !supportLists]-->· <!--[endif]-->myocarditis</p><p><!--[if !supportLists]-->· <!--[endif]-->acute myocardial infarction</p><p><!--[if !supportLists]-->· <!--[endif]-->scar tissue</p><p>Low values can occur in <sup>4</sup>:</p><p><!--[if !supportLists]-->· <!--[endif]-->lipomatous metaplasia/fat</p><p><!--[if !supportLists]-->· <!--[endif]-->thrombus</p><p>Influencing factors</p><p>Unlike native T1 extracellular volume (ECV)<strong> </strong>seems not to be dependant on field strength, but similar to native T1 it varies between systole and diastole <sup>2,4</sup>. There are only minor differences in regard to the myocardial region <sup>6</sup>. </p><p>See also</p><p>T1 mapping</p><p> </p>- +</v:shape><![endif]--><!--[if !vml]--><!--[endif]--><!--[endif]--></p><p><!--[if gte msEquation 12]><m:oMathPara><m:oMathParaPr><m:jc
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- +</v:shape><![endif]--><!--[if !vml]--><!--[endif]--><!--[endif]--></p><p>nT1 = native T1, pT1m postcontrast T1, my = myocardium, bp = blood pool , hct = haematocrit</p><h4>Interpretation</h4><p>It is of interest in the myocardium as a biomarker for interstitial disease. In the absence of any diffuse infiltrative disease or myocardial oedema, it can be also considered as a biomarker for fibrosis <sup>1-4</sup>.</p><p>Apart from fibrosis, it is elevated in the following myocardial diseases <sup>1-4</sup>:</p><ul>
- +<li>
- +<a href="/articles/cardiac-amyloidosis">cardiac amyloidosis</a><ul>
- +<li>ATTR-amyloidosis – prognostic value</li>
- +<li>AL-amyloidosis</li>
- +</ul>
- +</li>
- +<li><a href="/articles/myocarditis">myocarditis</a></li>
- +<li><a href="/articles/myocardial-infarction">acute myocardial infarction</a></li>
- +<li>scar tissue</li>
- +</ul><p>Low values can occur in <sup>4</sup>:</p><ul>
- +<li>lipomatous metaplasia/fat</li>
- +<li><a href="/articles/intracardiac-thrombi">cardiac thrombus</a></li>
- +</ul><h5>Influencing factors</h5><p>Unlike native T1 extracellular volume (ECV)<strong> </strong>seems not to be dependant on field strength, but similar to native T1 it varies between systole and diastole <sup>2,4</sup>. There are only minor differences in regard to the myocardial region <sup>6</sup>. </p><h4>See also</h4><p><a href="/articles/t1-mapping-myocardium">T1 mapping</a></p><p> </p>
References changed:
- 1. Moon J, Messroghli D, Kellman P et al. Myocardial T1 Mapping and Extracellular Volume Quantification: A Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology Consensus Statement. J Cardiovasc Magn Reson. 2013;15(1):92. <a href="https://doi.org/10.1186/1532-429X-15-92">doi:10.1186/1532-429X-15-92</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/24124732">Pubmed</a>
- 2. Messroghli D, Moon J, Ferreira V et al. Clinical Recommendations for Cardiovascular Magnetic Resonance Mapping of T1, T2, T2* and Extracellular Volume: A Consensus Statement by the Society for Cardiovascular Magnetic Resonance (SCMR) Endorsed by the European Association for Cardiovascular Imaging (EACVI). J Cardiovasc Magn Reson. 2017;19(1):75. <a href="https://doi.org/10.1186/s12968-017-0389-8">doi:10.1186/s12968-017-0389-8</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/28992817">Pubmed</a>
- 3. Ferreira V, Piechnik S, Robson M, Neubauer S, Karamitsos T. Myocardial Tissue Characterization by Magnetic Resonance Imaging: Novel Applications of T1 and T2 Mapping. J Thorac Imaging. 2014;29(3):147-54. <a href="https://doi.org/10.1097/RTI.0000000000000077">doi:10.1097/RTI.0000000000000077</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/24576837">Pubmed</a>
- 4. Haaf P, Garg P, Messroghli D, Broadbent D, Greenwood J, Plein S. Cardiac T1 Mapping and Extracellular Volume (ECV) in Clinical Practice: A Comprehensive Review. J Cardiovasc Magn Reson. 2016;18(1):89. <a href="https://doi.org/10.1186/s12968-016-0308-4">doi:10.1186/s12968-016-0308-4</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/27899132">Pubmed</a>
- 5. Schelbert E & Messroghli D. State of the Art: Clinical Applications of Cardiac T1 Mapping. Radiology. 2016;278(3):658-76. <a href="https://doi.org/10.1148/radiol.2016141802">doi:10.1148/radiol.2016141802</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/26885733">Pubmed</a>
- 6. Kawel N, Nacif M, Zavodni A et al. T1 Mapping of the Myocardium: Intra-Individual Assessment of the Effect of Field Strength, Cardiac Cycle and Variation by Myocardial Region. J Cardiovasc Magn Reson. 2012;14(1):27. <a href="https://doi.org/10.1186/1532-429X-14-27">doi:10.1186/1532-429X-14-27</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/22548832">Pubmed</a>
Tags changed:
- refs
Sections changed:
- Approach
- Imaging Technology
Systems changed:
- Cardiac