title: Detection and prediction of acute heart transplant rejection with the myocardial T2 determination provided by a black-blood magnetic resonance imaging sequence.
abstract: OBJECTIVE
  This study aimed to determine whether the myocardial T2 relaxation time, determined using a black-blood magnetic resonance imaging (MRI) sequence, could predict acute heart transplant rejection.
  
  
  BACKGROUND
  The use of black-blood MRI sequences allows suppression of the confusing influence of blood signal when myocardial T2 is calculated to detect myocardial edema.
  
  
  METHODS
  A total of 123 investigations, including cardiac MRI and myocardial biopsy, were performed 8 +/- 11 months after heart transplantation. Myocardial T2 was determined using an original inversion-recovery/spin-echo sequence.
  
  
  RESULTS
  A higher than normal T2 (> or = 56 ms) allowed an accurate detection of the moderate acute rejections evidenced at baseline biopsy (> or = International Society for Heart and Lung Transplantation grade 2): sensitivity, 89% and specificity, 70% (p < 0.0001). T2 was increased in grade 2 (n = 11) compared with grade 0 (n = 49, p < 0.05), grade 1A (n = 34, p < 0.05) and grade 1B (n = 21, p < 0.05); T2 was further increased in grade 3 (n = 8) compared with grade 2 (p < 0.05). In addition, in patients without rejection equal to or greater than grade 2 at baseline, a T2 higher than normal (> or = 56 ms) was correlated with the subsequent occurrence of equal or greater than grade 2 rejection within the next three months: sensitivity 63% (12/19) and specificity 78% (64/82) (p = 0.001).
  
  
  CONCLUSIONS
  Myocardial T2 determined using a black-blood MRI sequence, is sufficiently sensitive to identify most of the moderate acute rejections documented with biopsy at the same time, but is also a predictor of the subsequent occurrence of such biopsy-defined rejections.
authors.affiliation: Department of Nuclear Medicine, UPRES EA 2403, CHU Nancy, France. py.marie@chu-nancy.fr
authors.forename: P Y
authors.initials: PY
authors.lastname: Marie
authors.forename: M
authors.initials: M
authors.lastname: Angioï
authors.forename: J P
authors.initials: JP
authors.lastname: Carteaux
authors.forename: J M
authors.initials: JM
authors.lastname: Escanye
authors.forename: S
authors.initials: S
authors.lastname: Mattei
authors.forename: K
authors.initials: K
authors.lastname: Tzvetanov
authors.forename: O
authors.initials: O
authors.lastname: Claudon
authors.forename: N
authors.initials: N
authors.lastname: Hassan
authors.forename: N
authors.initials: N
authors.lastname: Danchin
authors.forename: G
authors.initials: G
authors.lastname: Karcher
authors.forename: A
authors.initials: A
authors.lastname: Bertrand
authors.forename: P M
authors.initials: PM
authors.lastname: Walker
authors.forename: J P
authors.initials: JP
authors.lastname: Villemot
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015150:Echocardiography, Doppler; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis*; D016027:Heart Transplantation / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged