The potential of mapping techniques in cardiac magnetic resonance imaging: Indications, diagnostic value, limitations and first experience in our center
Hirschberg Kristóf1, Dohy Zsófia1, Tóth Attila1, Szabó Liliána1, Czimbalmos Csilla1, Finster Marius1, Suhai Ferenc1, Merkely Béla1, Vágó Hajnalka1
1Semmelweis Egyetem, Városmajori Szív- és Érgyógyászati Klinika, Budapest
Cardiac magnetic resonance imaging (CMR) is an essential part of noninvasive diagnostics in cardiology according to several current guidelines of the European Society of Cardiology (ESC). In many cases, CMR provides unique information on cardiac pathology which cannot be replaced by other methods (e.g. in acute myocarditis, myocardial infarction with non-obstructive coronary arteries, rare cardiomyopathies, takotsubo syndrome, congenital heart diseases). In other cases, CMR confirms or completes a suspected diagnosis (e.g. dilatative cardiomyopathy, hypertrophic cardiomyopathy, infarct scars etc.). A widespread use is limited – despite the increasing needs – by the restricted availability, the high costs and some contraindications as well. Thus, a better availability and faster CMR examinations that provide even more information would be welcome. A contrast-agent free approach would also be beneficial. Some of the newly developed CMR sequences could clear the way for this purpose. Among others, so called mapping techniques are able to characterise myocardial tissue for edema and fibrosis. Both are very important in diverse pathological conditions. Mapping is a relatively new technique with a history of about a decade and with already a huge literature, partly with different aspects. Mapping is available since last summer at the Semmelweis University Heart and Vascular Center. This review work describes the theoretical basis of mapping techniques and the on-site experiences by the beginning of 2020. Some representative cases are presented in order to introduce the clinical applications, indications, diagnostic value and limitations of different mapping techniques.