Distribution and Clinical Significance of High Signal Intensity of the Myocardium on T2-Weighted Images in 2 Phenotypes of Hypertrophic Cardiomyopathy

• Published in: Journal of computer assisted tomography Vol. 39; no. 6; p. 951
• Main Authors: Amano, Yasuo, Aita, Kumiko, Yamada, Fumi, Kitamura, Mitsunobu, Kumita, Shinichiro
• Format: Journal Article
• Language: English
• Published: United States 01.11.2015
• Subjects: Adult; Aged; Aged, 80 and over; Cardiomyopathy, Hypertrophic - blood; Cardiomyopathy, Hypertrophic - pathology; Contrast Media; Female; Gadolinium DTPA; Humans; Image Enhancement; Magnetic Resonance Imaging; Male; Middle Aged; Myocardium - pathology; Observer Variation; Phenotype; Reproducibility of Results; Retrospective Studies; Risk; Syncope; Troponin T - blood
• ISSN: 1532-3145
• DOI: 10.1097/rct.0000000000000296

The aim of this study was to evaluate distribution and clinical significance of high signal intensity of the myocardium on T2-weighted images (T2-HI) in 2 phenotypes of hypertrophic cardiomyopathy (HCM). Thirty-six patients with asymmetrical septal HCM (ASH) and 18 patients with apical HCM (APH) and their 864 myocardial segments were investigated. The distribution of T2-HI was compared with that of late gadolinium enhancement (LGE), and the relationships between T2-HI and clinical risk markers were evaluated. T2 values of the T2-HI were estimated with T2 mapping. The T2-HI was observed in 18 segments (3.1%) in 13 patients with ASH (36.1%) and in 12 segments (4.2%) in 8 patients with APH (44.4%). It was often localized outside LGE. The presence of T2-HI was related to syncope in ASH (P = 0.016). Furthermore, it had higher T2 values (61.1 milliseconds) than the reference myocardium (47.3 milliseconds). High signal intensity of the myocardium on T2-weighted images often locates outside LGE and reflects myocardial damage, which is related to syncope in ASH.