{"doi":"10.1002/mrm.29956","title":"The impact of water exchange on estimates of myocardial extracellular volume calculated using contrast enhanced <scp>T<sub>1</sub></scp> measurements: A preliminary analysis in patients with severe aortic stenosis","abstract":"Abstract Purpose Guidelines recommend measuring myocardial extracellular volume (ECV) using T 1 ‐mapping before and 10–30 min after contrast agent administration. Data are then analyzed using a linear model (LM), which assumes fast water exchange (WX) between the ECV and cardiomyocytes. We investigated whether limited WX influences ECV measurements in patients with severe aortic stenosis (AS). Methods Twenty‐five patients with severe AS and 5 healthy controls were recruited. T 1 measurements were made on a 3 T Siemens system using a multiparametric saturation‐recovery single‐shot acquisition (a) before contrast; (b) 4 min post 0.05 mmol/kg gadobutrol; and (c) 4 min, (d) 10 min, and (e) 30 min after an additional gadobutrol dose (0.1 mmol/kg). Three LM‐based ECV estimates, made using paired T 1 measurements (a and b), (a and d), and (a and e), were compared to ECV estimates made using all 5 T 1 measurements and a two‐site exchange model (2SXM) accounting for WX. Results Median (range) ECV estimated using the 2SXM model was 25% (21%–39%) for patients and 26% (22%–29%) for controls. ECV estimated in patients using the LM at 10 min following a cumulative contrast dose of 0.15 mmol/kg was 21% (17%–32%) and increased significantly to 22% (19%–35%) at 30 min ( p = 0.0001). ECV estimated using the LM was highest following low dose gadobutrol, 25% (19%–38%). Conclusion Current guidelines on contrast agent dose for ECV measurements may lead to underestimated ECV in patients with severe AS because of limited WX. Use of a lower contrast agent dose may mitigate this effect.","journal":"Magnetic Resonance in Medicine","year":2023,"id":376155,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9455,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1138959,"name":"John Biglands","orcid":"0000-0002-1161-5022","position":1,"is_corresponding":false},{"id":1138960,"name":"David Broadbent","orcid":"0000-0002-5892-4762","position":2,"is_corresponding":false},{"id":328469,"name":"Peter Kellman","orcid":"0000-0002-9875-6070","position":3,"is_corresponding":false},{"id":342550,"name":"Kelvin Chow","orcid":"0000-0003-0698-1746","position":4,"is_corresponding":false},{"id":307117,"name":"John P. Greenwood","orcid":"0000-0002-2861-0914","position":5,"is_corresponding":false},{"id":1138961,"name":"Eylem Levelt","orcid":"0000-0002-3799-7102","position":6,"is_corresponding":false},{"id":96475,"name":"Sven Plein","orcid":"0000-0002-0997-4384","position":7,"is_corresponding":false},{"id":1138962,"name":"David L. Buckley","orcid":"0000-0001-6659-8365","position":8,"is_corresponding":false},{"id":1138958,"name":"Noor Sharrack","orcid":"0000-0001-5880-1722","position":0,"is_corresponding":true}],"reference_count":23,"raw_metadata":null,"created_at":"2026-07-19T01:16:28.318749Z","pmid":"38041477","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}