Table 1

Typical CMR fibrosis findings in common pathologies

LGET1 mapping
Ischaemic cardiomyopathy
  • Subendocardial involvement

  • Variable transmural extension

  • Coronary artery territory distribution

  • Quantitative native T1 may perform similarly to LGE for detecting chronic infarction

  • ECV and native T1 in non-infarcted myocardium appear to be elevated

DCM
  • Non-ischaemic distribution, often mid-wall/subepicardial

  • ECV and native T1 may be elevated

Aortic stenosis
  • Typically non-ischaemic mid-wall distribution

  • May have subendocardial involvement

  • ECV, iECV and native T1 may be elevated

  • Post-AVR findings vary depending on relative regression of cellular and extracellular constituents of myocardium.

Hypertrophic cardiomyopathy
  • Patchy non-ischaemic distribution in regions of focal wall thickening, or at the right ventricular insertion points in the septum

  • ECV and native T1 may be elevated, even in patients without LGE

Myocarditis
  • At least one focal lesion in non-ischaemic distribution; often inferolateral and subepicardial

  • Used in conjunction with T2 mapping and early gadolinium enhancement for oedema and hyperaemia

  • Native T1 may offer greater diagnostic accuracy in myocarditis than LGE and traditional Lake Louise criteria

  • Not specific for acute vs chronic myocarditis

Cardiac amyloidosis
  • Diffuse myocardial uptake

  • Difficult to null images —black blood pool rather than white

  • ECV and native T1 elevated and may quantify disease burden

Cardiac sarcoidosis
  • Non-specific appearances

  • Multi-focal, non-ischaemic distribution is suggestive

  • Native T1 may discriminate sarcoidosis from healthy controls

  • Regresses with anti-inflammatory therapy

  • AVR, aortic valve replacement; CMR, cardiovascular magnetic resonance; DCM, dilated cardiomyopathy; iECV, indexed extracellular volume; LGE, late gadolinium enhancement.