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Native T1 Mapping in Post-COVID Vaccine-related Myocarditis in a paediatric population in 3T: The Singapore Paediatric Hospital’s experience.1Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore, Singapore
Synopsis
Motivation: To present our experience with native T1 mapping in Post-COVID Vaccine-related myocarditis.
Goal(s): To evaluate paediatric native T1 mapping values in Post-COVID Vaccine-related myocarditis
Approach: Data was collated over August 2021 - August 2023 in 15 patients (13 boys and 2 girls), aged 9 to 16 years old. Patients were scanned in a 3 Tesla MRI scanner.
Results: Majority of T1 values ranged 1201-1250ms. 17 segments had T1 values above 1250ms which correlated with LGE, (mostly in the basal region), ranging 1256ms – 1606ms. Thus, we perceived the normal range of T1 values to be 1100ms-1250ms and those above as increased T1 values.
Impact: Our study evaluated the characteristics of post-COVID vaccine-related myocarditis, a relatively new disease, in children aged 9 to 16 years-old using native T1 Mapping at 3T MRI, filling up the current gap in data in paediatric myocardial native T1 values
Background: All patients had the Pfizer-BioNTech vaccine, with at least 2 doses each, 5 had a booster dose, while one had a second booster dose.
Methodology: Data was collated from August 2021- August 2023, in 15 patients (13 boys and 2 girls) with indications of Post-COVID vaccine-related myocarditis. Seven patients had follow-up scans; among whom one had three follow-ups; totalling 24 cases. Patients were aged 9 to 16 years old; median age was 14. For follow-up cases, patient’s ages were taken as their age during the first scan. Patients were scanned in a Siemens Skyra® 3T scanner using the Modified Look-Locker Inversion recovery (MOLLI) sequence. T1 values were obtained by sampling myocardial segments according to the American Heart Association’s 17-segment model of left ventricular anatomy. T1 mapping values were collated and compared with late gadolinium enhancement (LGE) results.
Results: Of 408 segments sampled, the majority of T1 values (179 segments) were between 1201-1250ms, basal (63 segments), mid-ventricular(68), and apical(48). This was followed by T1 values 1100- 1200ms (106 segments), with basal(43), mid-ventricular(41), and apical (22). In 17 segments, T1 values above 1250ms correlated with LGE, ranging 1256ms – 1606ms. Of these, 10 were in the basal region, 5 mid-ventricular, and 2 apical/apex. We therefore perceived the normal range of T1 values as 1100ms-1250ms and those above as increased T1 values.
Multiple cases presented higher T1 values in apical segments without LGE, likely due to breathing artefacts and region-of-interest (ROI) sampling errors. In 7 patients with follow-up scans, T1 values shifted towards lower ranges on all follow-up scan/s, except one.
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