• Cardiac Magnetic Resonance
• Myocardial disease
• T1 mapping

T1 mapping is a validated technique in cardiac magnetic resonance (CMR), however in real-life clinical practice its effectiveness to diagnose myocardial disease is still unclear.
We sought to compare native T1 mapping to conventional Late gadolinium enhancement (LGE) and T2-STIR techniques for the evaluation of a cohort of consecutive patients undergoing CMR for the suspicion of myocardial disease.
CMR was performed in 323 patients, 206 males (64%), mean age 54±8 years and in 27 age- and sex- matched healthy controls. LGE, T2-STIR and pre- and post-contrast T1 mapping were acquired as suggested by the SCMR position paper. The CMR findings of global and regional T1 mapping were compared to the respective results of LGE and T2-STIR techniques.
T1 mapping gave additive information in 6-12% of patients; it was particularly able in conditions with diffuse myocardial damage as cardiac amyloidosis, scleroderma and Fabry disease (additive role in 42%), but it was less effective in cardiac disease presenting with regional or segmental distribution of myocardial damage as myocardial infarction, HCM, myocarditis (additive role in 1%).
Results of the present study suggest that Conventional LGE/T2-STIR and T1 mapping are complementary techniques and should be used together in every CMR examination.