Table 1.
Use and significance of different CMR sequences applied for the evaluation of primary and secondary forms of DCM.
| Sequence | Information provided | CMR imaging features |
|---|---|---|
| Cine-SSFP | Regional and global biventricular function Ventricular mass and parietal wall thickness |
Dilated left or biventricular cavities Reduced ejection fraction (<40%) Parietal wall thickness normal or slightly reduced (<5.5 mm) |
|
| ||
| T2w-STIR | Myocardial free water content increase reflecting aspecific inflammatory changes | Regional hyperintense signal subendocardial involvement to rule out ischemic versus nonischemic acute disease |
|
| ||
| IR-CE or LGE | Tissue fibrosis/scar | (i) No enhancement (59%) (ii) Subendocardial or transmural enhancement indistinguishable from patients with previous infarction (iii) Patchy or longitudinal striae of mid-wall enhancement |
|
| ||
| T1-mapping | Depiction of diffuse myocardial fibrosis | Generation of T1 maps for the quantification of decay in myocardial signal intensity |
|
| ||
| MRS (hydrogen) | Assessment of myocardial cellular triglyceride | Still few data published |
|
| ||
| MRS (phosphorous) | Measurement of myocardial energetics | Reduction in PCr (~50%) and ATP (~35%), with concomitant decrease in PCr/ATP (~25%) |
SSFP: steady-state free precession; T2w-STIR: T2-weighted short-tau Inversion recovery; IR-CE or LGE: Inversion recovery contrast-enhanced or late gadolinium enhancement; MRS: MR spectroscopy; PCr: phosphocreatine; ATP: adenosine-5-triphosphate (ATP).