Can native T1 mapping sequence be used as a non-invasive alternative imaging tool to LGE sequence for evaluating DCM patients?

Background Myocardial fibrosis is the potential outcome of dilated cardiomyopathy (DCM). Cardiac MRI is considered one of the most essential imaging methods in DCM evaluation by using the late gadolinium enhancement (LGE) sequence and native T1 mapping technique. The study aimed to assess the diagnostic accuracy and reliability of the native T1 mapping technique for detecting myocardial fibrosis in DCM patients and correlate the values with the LGE in such a patient population. Results LGE was present in ten patients (33.33%) and 46 out of 480 myocardial segments (9.58%). T1 native values were significantly higher in the LGE group compared to the non-LGE group (P < 0.001). Furthermore, the non-LGE group showed higher T1 native values than the control group. Based on receiver operating characteristics (ROC) curves analysis, the best cut-off value of T1 native for the discrimination between normal myocardium and DCM was 1060 ms, while 1125 ms was the optimal cut-off value for LGE prediction among DCM patients (AUC; 0.919 and 0.904), respectively. Conclusions Native T1 mapping technique can be used as a simple, practical, and reproducible method for characterizing myocardial fibrosis in patients with DCM with high diagnostic accuracy and specificity.