title: Myocardial T2 mapping reveals age- and sex-related differences in volunteers.
abstract: BACKGROUND
  T2 mapping indicates to be a sensitive method for detection of tissue oedema hidden beyond the detection limits of T2-weighted Cardiovascular Magnetic Resonance (CMR). However, due to variability of baseline T2 values in volunteers, reference values need to be defined. Therefore, the aim of the study was to investigate the effects of age and sex on quantitative T2 mapping with a turbo gradient-spin-echo (GRASE) sequence at 1.5 T. For that reason, we studied sensitivity issues as well as technical and biological effects on GRASE-derived myocardial T2 maps. Furthermore, intra- and interobserver variability were calculated using data from a large volunteer group.
  
  
  METHODS
  GRASE-derived multiecho images were analysed using dedicated software. After sequence optimization, validation and sensitivity measurements were performed in muscle phantoms ex vivo and in vivo. The optimized parameters were used to analyse CMR images of 74 volunteers of mixed sex and a wide range of age with typical prevalence of hypertension and diabetes. Myocardial T2 values were analysed globally and according to the 17 segment model. Strain-encoded (SENC) imaging was additionally performed to investigate possible effects of myocardial strain on global or segmental T2 values.
  
  
  RESULTS
  Ex vivo studies in muscle phantoms showed, that GRASE-derived T2 values were comparable to those acquired by a standard multiecho spinecho sequence but faster by a factor of 6. Besides that, T2 values reflected tissue water content. The in vivo measurements in volunteers revealed intra- and interobserver correlations with R2=0.91 and R2=0.94 as well as a coefficients of variation of 2.4% and 2.2%, respectively. While global T2 time significantly decreased towards the heart basis, female volunteers had significant higher T2 time irrespective of myocardial region. We found no correlation of segmental T2 values with maximal systolic, diastolic strain or heart rate. Interestingly, volunteers´ age was significantly correlated to T2 time while that was not the case for other coincident cardiovascular risk factors.
  
  
  CONCLUSIONS
  GRASE-derived T2 maps are highly reproducible. However, female sex and aging with typical prevalence of hypertension and diabetes were accompanied by increased myocardial T2 values. Thus, sex and age must be considered as influence factors when using GRASE in a diagnostic manner.
authors: Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Moorenstraße 5, Düsseldorf, 40225, Germany. Florian.Boenner@med.uni-duesseldorf.de.
authors: Florian
authors: F
authors: Bönner
authors: Niko
authors: N
authors: Janzarik
authors: Christoph
authors: C
authors: Jacoby
authors: Maximilian
authors: M
authors: Spieker
authors: Bernhard
authors: B
authors: Schnackenburg
authors: Felix
authors: F
authors: Range
authors: Britta
authors: B
authors: Butzbach
authors: Sebastian
authors: S
authors: Haberkorn
authors: Ralf
authors: R
authors: Westenfeld
authors: Mirja
authors: M
authors: Neizel-Wittke
authors: Ulrich
authors: U
authors: Flögel
authors: Malte
authors: M
authors: Kelm
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009206:Myocardium / Q000473:pathology*; D019047:Phantoms, Imaging; D012737:Sex Factors
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