Quantification of myocardial fibrosis using noninvasive T2‐mapping magnetic resonance imaging: Preclinical models of aging and pressure overload

Noninvasive imaging of cardiac fibrosis is important for early diagnosis and intervention in chronic heart diseases. Here, we investigated whether noninvasive, contrast agent‐free MRI T 2 ‐mapping can quantify myocardial fibrosis in preclinical models of aging and pressure overload. Myocardial fibrosis and remodeling were analyzed in two animal models: (i) aging (15‐month‐old male CF‐1 mice vs. young 6‐ to 8‐week‐old mice), and (ii) pressure overload (PO; by transverse aortic constriction in 4‐ to 5‐month‐old male C57BL/6 mice vs. sham‐operated for 14 days). In vivo T 2 ‐mapping was performed by acquiring data during the isovolumic and early diastolic phases, with a modified respiratory and ECG‐triggered multiecho TurboRARE sequence on a 7‐T MRI. Cine MRI provided cardiac morphology and function. A quantitative segmentation method was developed to analyze the in vivo T 2 ‐maps of hearts at midventricle, apex, and basal regions. The cardiac fibrosis area was analyzed ex vivo by picro sirius red (PSR) staining. Both aged and pressure‐overloaded hearts developed significant myocardial contractile dysfunction, cardiac hypertrophy, and interstitial fibrosis. The aged mice had two phenotypes, fibrotic and mild‐fibrotic. Notably, the aged fibrotic subgroup and the PO mice showed a marked decrease in T 2 relaxation times (25.3 ± 0.6 in aged vs. 29.9 ± 0.7 ms in young mice, p = 0.002; and 24.3 ± 1.7 in PO vs. 28.7 ± 0.7 ms in shams, p = 0.05). However, no significant difference in T 2 was detected between the aged mild‐fibrotic subgroup and the young mice. Accordingly, an inverse correlation between myocardial fibrosis percentage (FP) and T 2 relaxation time was derived ( R 2 = 0.98): T 2 (ms) = 30.45 – 1.05 × FP . Thus, these results demonstrate a statistical agreement between T 2 ‐map–quantified fibrosis and PSR staining in two different clinically relevant animal models. In conclusion, T 2 ‐mapping MRI is a promising noninvasive contrast agent‐free quantitative technique to characterize myocardial fibrosis.