Role of Cardiac Magnetic Resonance in the Evaluation of Dilated Cardiomyopathy: Diagnostic Contribution and Prognostic Significance

Table 1

Use and significance of different CMR sequences applied for the evaluation of primary and secondary forms of DCM.

Sequence	Information provided	CMR imaging features
Cine-SSFP	Regional and global biventricular function; Ventricular mass and parietal wall thickness	Dilated left or biventricular cavities; Reduced ejection fraction (<40%); Parietal wall thickness normal or slightly reduced (<5.5 mm)
T2w-STIR	Myocardial free water content increase reflecting aspecific inflammatory changes	Regional hyperintense signal subendocardial involvement to rule out ischemic versus nonischemic acute disease
IR-CE or LGE	Tissue fibrosis/scar	(i) No enhancement (59%); (ii) Subendocardial or transmural enhancement indistinguishable from patients with previous infarction; (iii) Patchy or longitudinal striae of mid-wall enhancement
T1-mapping	Depiction of diffuse myocardial fibrosis	Generation of T1 maps for the quantification of decay in myocardial signal intensity
MRS (hydrogen)	Assessment of myocardial cellular triglyceride	Still few data published
MRS (phosphorous)	Measurement of myocardial energetics	Reduction in PCr (∼50%) and ATP (∼35%), with concomitant decrease in PCr/ATP (∼25%)

SSFP: steady-state free precession; T2w-STIR: T2-weighted short-tau Inversion recovery; IR-CE or LGE: Inversion recovery contrast-enhanced or late gadolinium enhancement; MRS: MR spectroscopy; PCr: phosphocreatine; ATP: adenosine-5-triphosphate (ATP).