Myocardial Effective Transverse Relaxation Time at 7.0 T Correlates with Left Ventricular Wall Thickness
Till Huelnhagen1, Teresa Serradas Duarte1, Fabian Hezel1, Erdmann Seeliger2, Bert Flemming2, Marcel Prothmann3, Jeanette Schulz-Menger3, and Thoralf Niendorf1,4

1Berlin Ultrahigh Field Facility (B.U.F.F), Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany, 2Institute for Physiology, Charité University Medicine, Berlin, Germany, 3Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany, 4Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicince in the Helmholtz Association, Berlin, Germany

Synopsis

This work examines the relationship of ventricular septal wall thickness and T2* at 7.0T in healthy volunteers. Results show, that T2* changes periodically over the cardiac cycle, increasing in systole and decreasing in diastole. A strong correlation between mean septal T2* and wall thickness was found. Temporally resolved field mapping showed that macroscopic magnetic field fluctuations can be excluded as source of the observed changes. While T2* is often regarded as surrogate for tissue oxygenation, the found systolic increase of T2* cannot be explained by increased oxygenation. Instead changes in blood volume fraction are assumed to be responsible for the observed T2* fluctuations.

Purpose

Magnetic susceptibility weighted cardiovascular MR (CMR) is an emerging (pre)clinical application in myocardial tissue characterization [1,2]. T2* weighted CMR is usually limited to single phase end diastolic acquisitions. Dynamic mapping of myocardial T2* allows probing the myocardium in different physiological states and holds the promise to facilitate distinction of healthy and pathologic tissue. High spatially and temporally resolved T2* mapping has been demonstrated in the in vivo human heart at 7.0T [3]. Myocardial BOLD contrast or T2* are commonly regarded as a surrogate for myocardial tissue oxygenation [2], but the factors influencing effective transversal relaxation times are numerous [4-6]. For meaningful interpretation of myocardial T2*, it is essential to identify influential factors and their contributions to T2*. This study examines the relationship of cardiac morphology and T2*, and demonstrates that T2* in the ventricular septum correlates with septal wall thickness across the cardiac cycle in healthy volunteers at 7.0T.

Methods

Ten healthy volunteers (7 male,age=40.8±15.6,BMI=22.8±3.2kg/m2) were examined using a 7.0T whole body MR system (Siemens Healthcare,Erlangen,Germany). A 16 channel transceiver array tailored for CMR at 7.0T was used for signal excitation/reception [7]. For CINE T2* mapping a cardiac triggered interleaved multi-echo gradient-echo technique (TE=(2.04-10.20)ms,spatial resolution=(1.1x1.1x4.0)mm3) was employed. Midventricular short axis views were acquired. Acoustic triggering (MRI.TOOLS GmbH,Berlin,Germany) was applied for detecting the onset of the cardiac cycle. T2* sensitized images were de-noised [8] and co-registered. The left ventricular myocardium was manually segmented for each cardiac phase and wall thickness was measured. T2* mapping was conducted using a mono-exponential signal decay model. R2 and T2* fit standard deviation (T2*-STD, [9]) were used as goodness of fit measures. Fitting results with R2<0.7,T2*-STD>3ms or (0ms>T2*>50ms) were excluded from further analysis to account for image artifacts. Only septal segments (segment 8,9 [10]) were evaluated since they have been shown to provide most reliable T2* [11]. Cardiac phases were unified to allow for averaging between subjects. Correlation of mean septal T2* and wall thickness was assessed employing Pearson correlation coefficient. To investigate macroscopic magnetic field fluctuations, temporally resolved field maps were calculated from phase images obtained by the pulse sequence used for T2* mapping for three volunteers in short axis and 4 chamber views.

Results

Figure 1 illustrates T2* maps of a mid-ventricular short axis view of one volunteer overlaid onto anatomical FLASH images over the cardiac cycle. Septal T2* was found to change across the cardiac cycle increasing in systole and decreasing in diastole. Mean septal wall thickness was found to be 7.4±1.6mm, mean T2* was 14.2±1.4ms. Mean end-systolic septal wall thickness and T2* were 9.1±1.3mm and 14.7±1.5ms. Mean end diastolic values were 6.1±1.0mm and T2*=13.7±1.3ms. The mean T2* variation over the cardiac cycle was 3.5±1.0ms. Figure 2a shows the time course of mean septal T2* and wall thickness averaged per cardiac phase for all volunteers. Figure 2b shows the same values in a scatter plot. A significant positive correlation was found between mean septal T2* and wall thickness (R=0.92,p<0.001). The mean temporal variation of the macroscopic intra-voxel magnetic field gradient in the septum was found to be 1.9±0.5Hz/voxel.

Discussion

This study investigated ventricular septal T2* and wall thickness at 7.0T with high spatio-temporal resolution in healthy volunteers. Cyclic changes of mean T2* were found over the cardiac cycle with an increase in systole and a decrease in diastole. This is in line with previous reports about myocardial BOLD signal intensity changes reporting increased BOLD signal in systole [12,13]. The found macroscopic magnetic field fluctuations can be considered minor and excluded as source of the observed T2* changes. While T2* is often regarded as surrogate for tissue oxygenation, the found systolic increase of T2* cannot be explained by increased oxygenation. Instead it is potentially dominated by changes in relative myocardial blood volume. When the ventricular muscle contracts in systole, ventricular myocardial wall stress is massively increased. This temporarily ceases blood influx into the left ventricular myocardium [14]. At the same time blood is squeezed out of it [14] thereby decreasing the blood volume fraction and the amount of deoxygenized blood per voxel, which induces a T2* increase. Another possible confounder could be mesoscopic variations in magnetic field homogeneity induced by changes of myocardial morphology during contraction and relaxation.

Conclusion

Ventricular septal T2* changes periodically during the cardiac cycle in healthy volunteers at 7.0T; increasing in systole and decreasing in diastole. Septal T2* correlates with septal wall thickness. Our findings suggest that blood volume fraction plays an important role in myocardial T2*. Temporally resolved MR relaxation mapping could be beneficial for understanding cardiac (patho)physiology in vivo.

Acknowledgements

No acknowledgement found.

References

[1] He (2014) Quant Imaging Med Surg 4(5):407, [2] Friedrich et al. (2013) JCMR 15:43, [3] Hezel et al. (2012) PLoS One 7(12):e52324, [4] Christen et al. (2012) MRM 67(5):1458, [5] Lee et al. (2011) Neuroimage 57(1):225, [6] Dibb et al. (2015) JCMR 17:60, [7] Thalhammer et al. (2012) JMRI 36(4):847, [8] Manjon et al. (2010) JMRI 31(1):192, [9] Sandino et al. (2015) JCMR 17(1):7, [10] Cerqueira et al. (2002) Circulation 105(4):539, [11] Meloni et al. (2014) MRM 71(6):2224, [12] Guensch et al. (2013) PLoS One 8(1):e53282, [13] Tsaftaris et al. (2013) Circ Cardiovasc Imaging 6(2):311, [14] Schmidt et al., Physiologie des Menschen (2010), 31., Springer

Figures

Figure 1: High spatial resolution cardiac phase resolved myocardial T2* maps of a mid-ventricular short axis view of a healthy volunteer at 7.0T overlaid onto FLASH CINE anatomical images (spatial resolution=1.1x1.1x4.0mm). A T2* increase can be observed in systole. Highest T2* values are found in ventricular septal segments. TT=time-to-trigger.

Figure 2: Relationship of ventricular septal wall thickness and T2* in healthy volunteers at 7.0T: A) Course of mean septal wall thickness and T2* across the cardiac cycle averaged for all volunteers. B) Scatter plot of mean septal T2* over mean septal wall thickness. A clear correlation can be observed.



Proc. Intl. Soc. Mag. Reson. Med. 24 (2016)
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