7 January 2024 | Nazario Carrabba, Mattia Alexis Amico, Andrea Igoren Guaricci, Maria Cristina Carella, Viviana Maestrini, Sara Monosilio, Patrizia Pedrotti, Fabrizio Ricci, Lorenzo Monti, Stefano Figliozzi, Camilla Torlasco, Andrea Barison, Andrea Baggiano, Alessandra Scatteia, Gianluca Pontone, Santo Dellegragottaglie
Cardiac magnetic resonance (CMR) mapping, particularly T1 and T2 mapping, has revolutionized cardiac imaging by providing quantitative insights into myocardial tissue properties. This review highlights the clinical significance of CMR mapping in diagnosing and managing various cardiac conditions, including ischemic heart disease, cardiomyopathies, inflammatory cardiomyopathies, aortic valve stenosis, arrhythmic mitral valve prolapse, and athlete's heart. T1 mapping assesses myocardial extracellular volume (ECV) and detects fibrosis, while T2 mapping identifies edema and myocardial injury. These techniques offer advantages over conventional CMR by providing objective, quantitative data, which is crucial for early detection and monitoring of disease progression. However, challenges remain in standardizing protocols and establishing reference values, which hinder widespread clinical adoption. Future developments should focus on standardization to enhance clinical applicability and improve patient outcomes. CMR mapping is particularly useful in diffuse conditions such as amyloidosis and Fabry disease, where conventional methods may lack sensitivity. In ischemic heart disease, T2 mapping differentiates between acute and chronic infarctions, while T1 mapping helps distinguish viable from non-viable myocardium. For cardiomyopathies, T1 and T2 mapping provide detailed insights into myocardial composition, aiding in diagnosis and treatment planning. In inflammatory cardiomyopathies, CMR mapping enhances diagnostic accuracy and risk stratification. In aortic valve stenosis, T1 mapping detects diffuse fibrosis, which is often missed by LGE. For arrhythmic mitral valve prolapse, CMR mapping identifies fibrosis and ventricular remodeling. In athlete's heart, CMR mapping helps differentiate adaptive remodeling from pathological conditions. Despite its potential, the lack of standardized protocols and reference ranges remains a barrier to broader clinical use. Standardization is essential for optimizing patient care and improving diagnostic accuracy in cardiac imaging.Cardiac magnetic resonance (CMR) mapping, particularly T1 and T2 mapping, has revolutionized cardiac imaging by providing quantitative insights into myocardial tissue properties. This review highlights the clinical significance of CMR mapping in diagnosing and managing various cardiac conditions, including ischemic heart disease, cardiomyopathies, inflammatory cardiomyopathies, aortic valve stenosis, arrhythmic mitral valve prolapse, and athlete's heart. T1 mapping assesses myocardial extracellular volume (ECV) and detects fibrosis, while T2 mapping identifies edema and myocardial injury. These techniques offer advantages over conventional CMR by providing objective, quantitative data, which is crucial for early detection and monitoring of disease progression. However, challenges remain in standardizing protocols and establishing reference values, which hinder widespread clinical adoption. Future developments should focus on standardization to enhance clinical applicability and improve patient outcomes. CMR mapping is particularly useful in diffuse conditions such as amyloidosis and Fabry disease, where conventional methods may lack sensitivity. In ischemic heart disease, T2 mapping differentiates between acute and chronic infarctions, while T1 mapping helps distinguish viable from non-viable myocardium. For cardiomyopathies, T1 and T2 mapping provide detailed insights into myocardial composition, aiding in diagnosis and treatment planning. In inflammatory cardiomyopathies, CMR mapping enhances diagnostic accuracy and risk stratification. In aortic valve stenosis, T1 mapping detects diffuse fibrosis, which is often missed by LGE. For arrhythmic mitral valve prolapse, CMR mapping identifies fibrosis and ventricular remodeling. In athlete's heart, CMR mapping helps differentiate adaptive remodeling from pathological conditions. Despite its potential, the lack of standardized protocols and reference ranges remains a barrier to broader clinical use. Standardization is essential for optimizing patient care and improving diagnostic accuracy in cardiac imaging.