DIAPO 1

Thanks doctor X for the introduction. In this presentation I will talk about
myocardial fibrosis and the usual quantification techniques in the standard cardiac
protocol. On the one hand I will talk about the evaluation for myocardial viability
and on the other hand I will consider the 2D T1 mapping.

DIAPO 2

To begin with, fibrosis is related to excess connective tissue formation, in

particular due to collagen fibers. It is associated secondarily with pathologies
such as ischemia, hypertension, viral infection or hypertrophic cardiomyopathy.

In images due to late enhancement with gadolinium, fibrosis appears hyperintense

and may be acute or diffuse.

DIAPO 3

A first patient, a man of 50 with dilatation of the left ventricle and septal
dyskinesia, with diffuse hypokinesia in the rest of the left ventricle.
Severe determination of systolic function with an ejection fraction of 17%.

Anterior intramyocardial fibrosis AS, IS, medial A, AS, IS and apical A, S.

Fraction of fibrosis of 18%.

We can see the pattern of acute fibrosis throughout the interventricular septum.
Here we see the identification of fibrosis for its quantification.

DIAPO 4

We can observe the extracellular volume map calculated from the native and post-
contrast T1 maps. The calculation of the fraction of fibrosis was found to be 18%
in total agreement with the measurement with myocardial viability.

DIAPO 5

A 68-year-old female patient with asymmetric septal hypertrophy. Diffuse myocardial

fibrosis

DIAPO 6

For its quantification, different thresholds were studied, whose images are shown
and the corresponding fraction of fibrosis was calculated

DIAPO 7

We can observe the extracellular volume map calculated from the native and post-
contrast T1 maps. The calculation of the fraction of fibrosis was found to be 85%.

DIAPO 8

If we compare the information that provides the myocardial viability and the T1
mapping, we see that the mapping detected greater diffuse fibrosis than the
viability.

For example, in the marked region we see fibrosis that viability did not detect.