Non-contrast T1 mapping can detect myocardial fibrosis in hypertrophic cardiomyopathy without gadolinium. Is native T1 a superior alternative to late gadolinium enhancement?

Native T1 mapping is a novel cardiac magnetic resonance technique for myocardial tissue characterization without contrast administration. Native T1-mapping in hypertrophic cardiomyopathy was correlated with T1 map-based extracellular volume fraction, and native T1 of apparently late gadolinium enhancement (LGE)-negative segments were significantly longer than normal myocardium. Therefore, native T1 mapping has the potential to quantify the volume of interstitial space without gadolinium, which would be useful particularly in patients who are limited in use of gadolinium. Furthermore, native T1 would be a useful biomarker for the detection of diffuse myocardial damage difficult to evaluate using conventional LGE alone.