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Abstract #4338

Can spleen T1 mapping be used as a marker of adequate adenosine response in stress perfusion CMR?

Sergio M. Solis-Barquero1,2, Veronica Aramendia-Vidaurreta1,2, Ana Ezponda1,2, Marta Vidorreta3, Marina Pascual4, Gorka Bastarrika1,2, and Maria A. Fernandez-Seara1,2
1Department of Radiology, Clinica Universidad de Navarra, Pamplona, Spain, 2Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain, 3Siemens Healthcare, Madrid, Spain, 4Department of Cardiology, Clinica Universidad de Navarra, Pamplona, Spain

Synopsis

Keywords: Myocardium, Ischemia, Spleen

Motivation: There is limited existing data regarding T1 mapping as a method for assessing splenic switch-off.

Goal(s): To further investigate quantitative T1 mapping for splenic switch-off assessment as a marker of adequate response to adenosine in stress in CMR perfusion studies for improving test accuracy and mitigating the occurrence of false-negatives.

Approach: Prospective CMR with first-pass perfusion and T1 mapping at rest and stress in 59 patients at 1.5T.

Results: Splenic T1 values decreased from rest to stress in patients with switch-off. T1 mapping detected splenic switch-off in a clinical population with a specificity of 75% and sensitivity of 80% (ΔT1 threshold of -5.5ms).

Impact: This study suggest that splenic T1 changes can detect splenic switch-off during adenosine stress CMR, potentially enabling real-time stress adequacy assessment. However, it raises questions about adenosine’s effects on splenic perfusion and the link of splenic switch-off to myocardial response.

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