T1 mapping of the ischemic myocardium: Review of potential clinical use

Highlights: • T1 mapping is a feasible method for detailed characterization of the myocardium. • Non-contrast T1 mapping has potential for precise quantification of myocardial edema in acute infarction. • Evaluation of non-contrast T1 maps and extracellular volume improve detection of the area at risk and final infarct size. • T1 mapping could be beneficial in the quantification of chronic fibrous scar of the myocardium. - Abstract: Cardiac magnetic resonance imaging (CMR) is an indispensable part of the diagnostic algorithm in cardiology. CMR has become a gold standard in various disorders; moreover, it is well established also as a surrogate end-point in experimental and clinical studies. Particularly, the ability to directly display myocardial injury is a unique feature in comparison with other methods. The mapping of magnetic relaxation properties (T1, T2 and T2* relaxation times) are still relatively new techniques, but promising to improve the robustness of CMR and add new appropriate indications. The high potential of T1 mapping in the diagnostic of myocardial ischemic involvement has been highlighted in several experimental and clinical studies, but the use in clinical routine was limited due to the shortcomings in scanning and image evaluation. However, the quantitative technique of T1 mapping is now commercially available and its simple use, good reproducibility and limited subjectivity allow its incorporation into routine CMR protocols. This review article is aimed to summarise existing results and clinical experience with T1 mapping in patients with ischemic cardiac disease.