Radiology. 2026 Oct;321(1):e252886. doi: 10.1148/radiol.252886.
ABSTRACT
Background The clinical utility of quantitative T1 mapping in cardiac MRI is constrained by variability across acquisition protocols, and a comprehensive comparison between commonly used sequences remains unavailable. Purpose To provide a full range of cardiac MRI native T1 and extracellular volume fraction (ECV) values at 3 T in healthy Chinese adults and participants with various cardiovascular diseases and, as a secondary aim, to establish the relationship between modified Look-Locker inversion recovery (MOLLI) and shortened MOLLI (ShMOLLI) measurements. Materials and Methods This prospective study included healthy volunteers, participants with normal cardiac MRI findings, and participants representing 13 cardiovascular conditions. All participants underwent 3-T cardiac MRI with both MOLLI and ShMOLLI sequences during a single examination. Global native T1 and ECV values were quantified and compared between sequences and across disease groups. Statistical approaches included t tests, Pearson correlation, Bland-Altman analysis, and Cohen D standardization. Results This study included 1237 clinical participants (mean age ± SD: 51 years ± 14.8; 854 men). Reference values (adjusted mean ± SE) in healthy volunteers were 1170 msec ± 9 (MOLLI) and 1135 msec ± 10 (ShMOLLI) for native T1 and were 24.8% ± 0.6 (both MOLLI and ShMOLLI) for ECV, with women showing higher native T1 values than men (all P ≤ .002). MOLLI yielded systematically higher native T1 than ShMOLLI across all conditions (mean difference: 46.0 msec ± 27.2; all P < .01), whereas ECV did not differ for most conditions (10 of 15 groups; P > .05). Strong intersequence correlations were observed for native T1 (Pearson r = 0.93; P < .001) and ECV (r = 0.95; P < .001). After standardization to sequence-specific baselines, pathologic deviations were comparable between sequences (Cohen D differences ≤0.5 in most groups). A supplementary swine study supported the technical validity of both sequences (r = 0.87-0.90; P < .001). Conclusion In participants who underwent 3-T cardiac MRI with both MOLLI and ShMOLLI sequences, native T1 was higher with MOLLI than ShMOLLI, but ECV was consistent across sequences. © RSNA, 2026 Supplemental material is available for this article. See also the editorial by Dacher and Cadour in this issue.
PMID:42867375 | DOI:10.1148/radiol.252886