Dark-blood late gadolinium enhancement without additional magnetization preparation

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dc.contributor.authorBotnar, René Michael
dc.contributor.authorHoltackers, Robert J.
dc.contributor.authorChiribiri, Amedeo.
dc.contributor.authorSchneider, Torben.
dc.contributor.authorHiggins, David M.
dc.date.accessioned2019-10-17T14:25:02Z
dc.date.available2019-10-17T14:25:02Z
dc.date.issued2017
dc.date.updated2019-10-14T19:00:24Z
dc.description.abstractAbstract Background This study evaluates a novel dark-blood late gadolinium enhancement (LGE) cardiovascular magnetic resonance imaging (CMR) method, without using additional magnetization preparation, and compares it to conventional bright-blood LGE, for the detection of ischaemic myocardial scar. LGE is able to clearly depict myocardial infarction and macroscopic scarring from viable myocardium. However, due to the bright signal of adjacent left ventricular blood, the apparent volume of scar tissue can be significantly reduced, or even completely obscured. In addition, blood pool signal can mimic scar tissue and lead to false positive observations. Simply nulling the blood magnetization by choosing shorter inversion times, leads to a negative viable myocardium signal that appears equally as bright as scar due to the magnitude image reconstruction. However, by combining blood magnetization nulling with the extended grayscale range of phase-sensitive inversion-recovery (PSIR), a darker blood signal can be achieved whilst a dark myocardium and bright scar signal is preserved. Methods LGE was performed in nine male patients (63 ± 11y) using a PSIR pulse sequence, with both conventional viable myocardium nulling and left ventricular blood nulling, in a randomized order. Regions of interest were drawn in the left ventricular blood, viable myocardium, and scar tissue, to assess contrast-to-noise ratios. Maximum scar transmurality, scar size, circumferential scar angle, and a confidence score for scar detection and maximum transmurality were also assessed. Bloch simulations were performed to simulate the magnetization levels of the left ventricular blood, viable myocardium, and scar tissue. Results Average scar-to-blood contrast was significantly (p < 0.001) increased by 99% when nulling left ventricular blood instead of viable myocardium, while scar-to-myocardium contrast was maintained. Nulling left ventricular blood also led to significantly (p = 0.038) higher expert confidence in scar detection and maximum transmurality. No significant changes were found in scar transmurality (p = 0.317), normalized scar size (p = 0.054), and circumferential scar angle (p = 0.117). Conclusions Nulling left ventricular blood magnetization for PSIR LGE leads to improved scar-to-blood contrast and increased expert confidence in scar detection and scar transmurality. As no additional magnetization preparation is used, clinical application on current MR systems is readily available without the need for extensive optimizations, software modifications, and/or additional training.
dc.fuente.origenBiomed Central
dc.identifier.citationJournal of Cardiovascular Magnetic Resonance. 2017 Aug 23;19(1):64
dc.identifier.doi10.1186/s12968-017-0372-4
dc.identifier.urihttps://doi.org/10.1186/s12968-017-0372-4
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/26694
dc.identifier.wosidWOS:000408320400001
dc.issue.numeroNo. 64
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final10
dc.pagina.inicio1
dc.revistaJournal of Cardiovascular Magnetic Resonancees_ES
dc.rightsacceso abierto
dc.rights.holderThe Author(s).
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.subject.otherMiocardioes_ES
dc.subject.otherCicatrizes_ES
dc.subject.otherCorazón - Imagenes_ES
dc.subject.otherResonancia magnéticaes_ES
dc.titleDark-blood late gadolinium enhancement without additional magnetization preparationes_ES
dc.typeartículo
dc.volumenVol. 19
sipa.codpersvinculados1015313
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